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thesis entitled

Validation Of A Home-Based Observation
System For Use With Famiiies Of
Hyperactive Children

presented by
Ronald Aaron Lapporte

has been accepted towards fulfillment
of the requirements for

M.A . degree in Psychology

Major professor

Nade Horn

Date A 19 87

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Validation Of A Home-Based Observation System
For Use With Families Of Hyperactive Children

BY

Ronald Aaron Lapporte

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Psychology

1987

Copyright by
Ronald Aaron Lapporte
1987

ABSTRACT

Validation Of A Home-Based Observation System
For Use With Families Of Hyperactive Children

BY

Ronald Aaron Lapporte

The present study was designed to devise and validate a home-
based, mealtime observation code to distinguish normal children and
their families from hyperactive children and their families using 20
minute videotapes. A 17-category observation code was used to record
child and family interactions of 41 hyperactive children and their
families and 18 non-hyperactive control families. Adequate or
marginally adequate interobserver reliability coefficients were found
for approximately half of the codes. Infrequently scored codes
suffered from low reliability while the more frequent and more reliable
codes tended to correlate with behavior ratings made by parents and
teachers, and to discriminate between the diagnostic groups. More
specifically, hyperactive children received more commands from parents
and exhibited more non-compliance. The non-hyperactive families
exhibited more total and positive interactions than hyperactive
families. Although some of the codes are felt to be reliable and
valid, various means for further improving interobserver reliability

are offered.

ACKNOWLEDGMENTS

I would like to thank the individuals who greatly deserve my
gratitude for their participation and help on this project.

This thesis would not have been possible if it were not for the
unabated efforts of the many Psychology 490 students who worked with
me. Deserving special thanks are the groups of coders whose interest
and determination far exceeded my expectations and ability to reward
them. Above all, I would like to thank Debbie Rose for the
incalculable hours she has devoted to this project and her unyielding
support and friendship.

My committee deserves a special thanks for their support and
guidance through this rather lengthy project. Wade Horn, my chairman,
provided a model of proficiency and clarity of thought which greatly
helped me to sharpen my own critical thinking. As both a mentor and an
advisor, he has instilled in me a model of competence and
accountability that I am sure will stay with me throughout my
professional career.

Neal Schmitt, Mark Rilling and Gary Stollak each contributed to
the successful completion of this project. Neal Schmitt, who acted as
my co-chairman during the later phases of this project, was invaluable
as a statistical and analytical consultant. His willingness to listen
and guide me toward apprOpriate resources greatly fostered my

attainment of knowledge in the area of test construction. This

iv

knowledge was not only essential for the design and analysis of this
thesis but should continue to prove indispensable in my future research
undertakings and in my role as a consumer of other researchers'
efforts.

Mark Rilling's support, faith, and sincere appreciation of my
efforts offered considerable comfort through some of the more strenuous
periods. Since my first meeting with Mark, I have always felt that he
was a strong believer and advocate of my ambition and ability to be a
successful graduate student.

Due to logistical and timing problems making it impossible for
Wade Born to attend my oral defense, Gary Stollak was asked, and
graciously accepted my offer to serve as an additional committee
member. Gary's accommodating style and willingness to join my
committee with such short notice was truly appreciated.

Finally, my family and friends who offered encouragement and
support from the project's inception. A special thanks to Jim Yeomans,
Brian Hults, and Nick Ialongo for their practical guidance and

interest, and again to Debbie Rose for her efforts and caring.

TABLE OF CONTENTS

LI ST OF TABLES . C O O O O O O 0

Chapter 1 - Statement of the Problem . .
Chapter 2 - Review of the Literature .

Prevalence and Symptomatology . . . .
Assessment . . . . . . . . .

Previous Observation Codes . . . . .
Selected Behavior Items and Hypotheses .

Chapter 3 - Method . . . . . . . . .
Subjects . . . . . . . . . . .

Procedure and Study Design . . . . .
Design of the Code. . . . . . . .

Coding Procedure and Development of the Cod

Item Selection . . . . . . . . .
Training Coders. . . . . . .

Chapter 4 " Resu1t30 o o o o o o o 0
Reliability 0 O O O O O O O O I
Intercorrelations Among Behavioral Codes
Analysis of the Demographic Variables .
Construct Validity. . . . . . .

Chapter 5 - Discussion. . . . . . . .

Future Directions for Research. . . .

Appendices
Appendix A - Tables . . . . . .
Appendix B - The Observation Code. . .
Appendix C - Videotape Procedures. .
Appendix D - Coding Sheets . . . . .
Appendix E - Instruments. . . . . .

References. . . . . . . . . . .

vi

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36

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36
39
40
42
46

50

50
52
55
57

67

74

78
82
98
103
105

115

Table

10

11

12

13

LIST OF TABLES

List of all variables and their abbreviations .

Effective percent agreement mean reliability
coefficients, and range of reliability scores
for all behavioral codes . . . . . . .

Cohen's Kappa mean reliability coefficients, and
range of reliability scores for all behavioral
cades O C O O I O I O I O O O O O

Intercorrelations among behavioral observation
codes of r>.60. . . . . . . . . . .

Means and standard deviations for sex, age, grade
and the PPVT standard score for hyperactive
(Nhél) and control (Nh18) . . . . . . .

Correlation coefficients and significance levels
for all codes with Mother Conners, Teacher
Conners and the PIC-R Family Relations Scale.

F-statistics for Child and Other Interaction
variables . . . . . . . . . . . .

F-statistics for Family Interaction variables .
F-statistics for Command variables . . . . .
F-statistics for Compliance variables . . . .

F-statistics for Parent Positive Statements,
Inappropriate, and Out of Seat . . . . .

Pearson correlation coefficients and significance
levels for all variables (excluding diagonals)

Means and standard deviations for all behavioral

codes and caretaker checklists of child
behavior. . . . . . . . . . . . .

vii

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66

66

66

78

81

Chapter 1

Statement of the Problem

Hyperactivity is the most frequently referred problem to child
guidance clinics in the United States (Safer and Allen, 1976).
Although there is some difficulty determining accurate prevalence
estimates, Barkley (1981a) reports that most investigators accept an
estimate of between 3-52 of the school-age children. Primary problems
include non-compliance, overactivity, inattention, impulsivity,
attention seeking behaviors, clumsiness, difficulty accepting
discipline, and an inability to inhibit activity to situational demands
(Barkley, 1981a; Barkley, 1981b; Cantwell, 1975; Ross and Ross, 1976;
Routh, 1978; Safer and Allen, 1976).

Associated difficulties include behavioral and social problems
such as aggression, distractibility, poor peer relations, self-esteem
deficits, and high rates of risk-taking behavior (Barkley, 1981a;
Paternite and Loney, 1980). Academic and cognitive deficits are also
quite frequent. One study (Cantwell and Satterfield, 1978) found that
761 of their hyperactive sample were underachieving in at least two
academic subjects. Studies of hyperactive children in their teenage
and young adult years have shown that they do not outgrow the disorder
and that their problems persist (Shaffer, McMamara and Pincus, 1974;
Cantwell, 1978; Minde, Weiss, and Mendelson, 1972; Ross and Ross,
1976).

A variety of assessment tools are commonly utilized to diagnose
hyperactivity, identify co-existing physical, cognitive and behavioral

deficits, and evaluate treatment outcomes. Among these assessment

2
tools are interviews, rating scales, and objective observation which
may be utilized with different informants and across situations.

Interviews may be conducted with parents, teachers and the target
child. Although justifiably criticized for its possible unreliability,
the parental interview serves to provide important information as well
as other critical functions, such as establishing rapport. As Barkley
(1981a) points out, the parent is likely to have the greatest wealth of
knowledge about, history of interactions with, and time spent with the
child, of any possible source. Interviews with the child may also
provide information regarding the child's behavior, language and social
skills, although the style and quality of their responses may be more
important than their content (Barkley, 1981a). Teachers, having the
advantage of many comparison subjects, may provide a very useful
description of the child's social, cognitive and emotional functioning
in comparison to his peers (Ciminero and Drabman, 1977; Ollendick,
1981).

Behavior rating scales often make up a large portion of the
assessment procedure. These are usually filled out by parents and/or
teachers and serve as a means to objectify and quantify adult opinion
about a child. Among the best standardized and most commonly used
parent questionnaires are the 48 item and the 10 item versions of the
Conners Parent Symptom Questionnaire (1970), the Achenbach Child
Behavior Checklist (1978), and the Personality Inventory for Children
(Wirt, Lacher, Klinedinst, and Seat, 1977). Questionnaires completed
by teachers found to be helpful in the diagnosis of hyperactivity

include the Conners Teacher Rating Scale (1969) and the Behavior Rating

3
Scale (Kendall and Wilcox, 1979). Although many of these scales have
been shown to adequately discriminate hyperactive from normal children,
their reliability is in question due to parents tendency to
overestimate treatment efficacy (Walter and Gilmore, 1973; Patterson
and Reid, 1973).

Direct observations in a home, school, or clinic setting have been
argued to be the most representative of the situations in which the
problem behaviors occur. With respect to the home setting, Barkley
(1981a, p. 147) states "... measures of maternal commands, child
compliance, maternal contingent praise, parent and child negative
behavior, and positive interactions would appear to be of great
assistance in planning treatment and measuring improvements in response
to treatment." Although a more thorough list of objectives would
include a focus on the important, and commonly ignored father-child
interaction (Hughes and Haynes, 1978), the list provides many
appropriate goals for any objective observation system.

A multi-setting code for assessing parent child interactions
described by Mash, Terdal and Anderson (1973) uses two coders to record
the parent and child behaviors. Although this system can be used in
the home, school, or clinic settings, it is most often used in a clinic
analogue setting (Cunningham and Barkley, 1978; Barkley and Cunningham,
1979b). This system has the advantage of allowing for the evaluation
of antecedent and consequent interactions. The system puts constraints
and direction on behavior in that it requires 15-20 minutes of free
play and 15-20 minutes of task accomplishment. Roberts, Ray and

Roberts (1984), use a playroom observation setting to assess

4
hyperactive children in three instructional sets: free-play,
restricted-play and a restricted-homework situation in which the child
is instructed to work on arithmetic problems and left alone.

Perhaps the most well researched coding system to assess
hyperactivity in the school setting is the Stony Brook System by
O'Leary, Pelham and Rosenbaum (1976) and its modified form (Abikoff,
Gittelman-Klein and Klein, 1977; Abikoff, Gittelman, and Klein, 1980).
This code has proven to be highly sensitive in discriminating
hyperactive from normal children as well as assessing treatment effects
(Gittelman-Klein, Klein, Abikoff, Katz, Gloisten, and Kates, 1976;
Abikoff et a1., 1977; Abikoff, Gittelman, and Klein, 1980). However,
this system fails to record antecedent and consequent events and was
not designed to measure family interaction patterns. The Stony Brook
System assesses only individual child behaviors including interference,
off-task behavior, minor motor and gross motor movements, and
solicitation.

Elaborate and well standardized coding systems for use with
noncompliant or conduct problem children have been designed by Forehand
(Forehand et a1., 1978), and by Patterson et al. (Patterson, Ray, Shaw,
and Cobb, 1969). Both of these systems evaluate child and parent
interaction in the home using live observation. Forehand constricts
and records only interactions between the target child and the parents.
The Patterson system allows for evaluation of the target child with his
entire family. Although neither of these systems was designed for use
with hyperactive children, Patterson (1982) reports that one-fifth of

his sample of conduct disordered children had been previously diagnosed

5
as hyperactive. Many of the behaviors scored by the two forementioned
codes seem to be of great relevance to the hyperactive population and
their family interactions. However, these systems were designed to
address the specific behaviors of the conduct disordered population and
are not designed for, or standardized on, the hyperactive population.
Hence, although many of the behaviors measured by these systems are
also applicable for use with hyperactive children, others are less
relevant or restricted to specific settings.

To date, no direct observation coding system, designed to assess
the interactions of hyperactive children during mealtime has been
published. Evidence seems to support the belief that mealtime would be
an appropriate time to observe these families (Goodenough, 1931;
Barkley, 1981a) and that the development of a home observation coding
system for this population may improve the generalizability of research
findings to the home environment. Mealtime observation may be done
with only minimal restraints placed upon the family members in the
hopes of increasing the representativeness of the observation as
typical family interaction.

The purpose of this study is to design a coding system to measure
family interaction and individual child behaviors to discriminate
hyperactive children and their families from normal families using 20
minute in-home observations taken during mealtime. Specifically, the
goals are to design a code capable of: (a) demonstrating adequate
interobserver reliability, (b) demonstrating adequate construct
validity as evidenced by significant correlations between the
behavioral codes and caretaker checklists, and (c) discriminating

between hyperactive children and a normal control sample.

Chapter 2

Review of the Literature

 

Prevalence and Symptomatology

Although hyperactivity is the most frequently referred problem to
child guidance clinics in the United States (Safer and Allen, 1976), an
accurate estimate of its prevalence has been difficult to determine.
Due in part to the lack of acceptance of a single definition, estimates
as high as 202 of the school-age population (Barkley, 19813) and as low
as just over 1% of the same population have been reported (Sandoval,
Lambert, Sassone, 1980; Lambert, Samdoval, and Sassone, 1978; Rutter,
1977). Barkley (1981a) reports that most investigators accept a
prevalence estimate of 3-52 of the school-age children.

One comprehensive definition offered by Barkley (1981a, p. 6.)
describes hyperactivity as a "developmental disorder of age appropriate
attention span, impulse control, restlessness, and rule governed
behavior that develops in late infancy or early childhood (before age
6), is pervasive in nature, and is not accounted for on the basis of
gross neurologic, sensory, or motor impairment, or severe emotional
disturbance.” These symptoms comprise a heterogeneous group and vary
as a result of the effects of several factors including 888 (Laney,
1978) and daily situational or environmental changes (Barkley, 1981a;
Patterson, 1982; Goodenough, 1931).

The most commonly cited primary problems associated with
hyperactivity in children include non-compliance, overactivity,
inattention, impulsivity, attention seeking behaviors, clumsiness,
difficulty accepting discipline, and an inability to inhibit activity
to situational demands (Barkley, 1981a; Barkley, 1981b; Cantwell, 1975;
Ross and Ross, 1976; Routh, 1978; Safer and Allen, 1976).

6

7

Associated problems, whether caused by the primary symptoms or
just related problems of lesser frequency, are also commonly cited in
the literature. Included are behavioral and social problems such as
aggression, distractability, difficulty with peer relations, self-
esteem deficits, and high rates of risk taking behavior (Barkley,
1981a; Paternite and Loney, 1980). Academic and cognitive deficits are
also quite frequent. One study (Cantwell and Satterfield, 1978) found
that 762 of their hyperactive sample were underachieving in at least
two academic subjects. Although no single learning disability has been
shown to be more prevalent than others, Barkley (1981a) reports that
some authorities estimate that as many as 602 to 80% of hyperactive
children have some learning problems.

Studies of hyperactive children in their teenage and young adult
years have shown that they do not outgrow the disorder and that their
problems persist. Adolescence finds them still suffering from problems
with restlessness and inattention as well as conduct disorders,
including delinquency, stealing, lying, and more legal trouble than
normal adolescents (Shaffer et a1., 1974; Cantwell, 1978; Minde et a1.,
1972; Ross and Ross, 1976). By adolescence, many of these children ‘
have been held back at least one grade and may be achieving several
grades below their grade placement (weiss, Hechtman, and Perlman,
1978). Hyperactive adolescents have been found to be more likely to
abuse alcohol than nonrhyperactive, learning disabled adolescents
(Blouin, Bornstein, and Trites, 1978). Many of these problems persist

into adulthood, although often somewhat abated (Weiss et a1., 1978).

8

Attempts to classify the relatively heterogeneous hyperactive
population into more homogeneous subgroups have been controversial.
Classifications based on organic versus emotional factors were
described by Conrad and Insel (1967). Classification according to the
presence or absence of conduct disorders has also been proposed (Lahey,
Green and Forehand, 1980; Barkley, 1981a). An alternative approach,
described in the DSMEIII differentiates Attention Deficit Disorder
according to presence or absence of hyperactivity. Support for this
distinction has been empirically demonstrated (Cantwell, 1984; Lahey et
a1., 1984; Edelbrack, 1984), although further studies will be necessary
before widespread acceptance can be achieved.

According to Barkley (1981s), we are best off assuming that a
homogeneous syndrome of hyperactivity does not exist and that a
reliable means of subclassifying groups has yet to be found. He
elaborates by stating that ”the term hyperactivity as it is currently
used refers to a heterogeneous group of children, some overactive, some
inattentive, some impulsive, and others having all of these problems”
(Barkley, 1981b p. 130.). Studies have shown that the primary problems
of hyperactivity, including high levels of activity and
distractability, do not significantly ca-vary (Barkley, 1977; Barkley
and Ullman, 1975). Langharn, Laney, Paternite and Bechthaldt (1976),
using a factor analytic design, discovered that measures of different
symptoms from a common source are more highly interrelated than are
alternative measures of a single symptom. This may be interpreted as
evidence for environmental specificity of primary hyperactive symptoms.
Such an interpretation would also argue against trait research for the

study of hyperactivity.

9

Although a great deal of research has been conducted with
hyperactive children, much confusion and disagreement remains in our
current conceptualization of the disorder. The associated problems of
the hyperactive child affect not only his development but also appear
to negatively affect his family and society as well. The estimated
prevalence of the disorder, the variety and inconsistency of reported
problematic symptoms, its pervasive nature, and poor prognosis make
this disorder worthy and in need of continued research.

Assessment

 

Many assessment instruments have been utilized within the ever-
growing body of research literature on hyperactivity. Chief among the
goals of these instruments are the diagnosis of hyperactivity, the
identification of common co-existing physical, cognitive, and
behavioral deficits, and the evaluation of treatment outcomes. A
thorough assessment aids in locating problem areas and hence guides the
examiner to design effective interventions. One of the necessary
criteria for establishing problem areas is the assessment of multiple
behaviors across situations. Interviews, rating scales, and objective
observation may be utilized with different informants and across
situations in order to yield the necessary information.

An indispensable part of any assessment of hyperactivity is the
parental interview. Although the reliability of these interviews may
be questioned, the parental interview serves to provide important
information as well as other critical functions, such as establishing
rapport. As Barkley (1981a) points out, the parent is likely to have

the greatest wealth of knowledge about, history of interactions with,

10
and time spent with the child, of any possible source. By structuring
questions to inquire about specific and concrete behaviors, as opposed
to those of a more global nature, the reliability of the interview can
be greatly increased (Barkley, 1981a; Hartsough and Lambert, 1982).
When possible, conjoint interviews may also prove invaluable for
observing parental interactions.

Interviews with the child may also provide information regarding
the child's behavior, language, social skills, and perceptions of their
difficulties. The style and quality of their responses may be more
important than their content (Barkley, 1981a). Barkley (1981a) reports
that these children are prone to fabricate or distort their responses
and hence are unlikely to be a good source of additional detail.
However, the interview situation allows the examiner to detect and help
modify misconceptions pertaining to the child's referral. Due to the
situational influence on many of the referral problems, caution should
be used when extrapolating observations of behaviors in the clinical
setting to other outside settings (Barkley, 1981a). Behaviors
exhibited in the examiner's office are likely to be unrepresentative of
the serious management problems that these children present at home or
at school (Barkley, 1981a).

The teacher interview, whether in person or by phone, may provide
additional useful information and allow the examiner to probe for
specific information surrounding a given problem. Having the advantage
of many comparison subjects, teachers may provide a very accurate
description of the child's social, cognitive and emotional deficits in

comparison to his peers and his likelihood of developing school

11
problems (Ciminero and Drabman, 1977; Ollendick, 1981). Establishing
rapport with the teacher may prove invaluable beyond the initial
assessment phase, as teachers are often key participants in treatment
and treatment evaluation. As with parent interviews, examiners may
need to inquire about specific behaviors and surrounding events in
order to increase the reliability and utility of the teacher's
information.

Behavior rating scales may make up a large portion of the
assessment procedure. These are usually filled out by parents and/or
teachers and serve as a means to objectify and quantify adult opinion
about a child. According to Barkley (19813) the areas of hyperactivity
and conduct problems have fostered the growth of more rating scales
than any other area of child psychotherapy.

Among the best standardized and most commonly used parent
questionnaires are the 48 item and the 10 item versions of the Conners
Parent Symptom Questionnaire (1970), the Achenbach Child Behavior
Checklist (1978), and the Personality Inventory for Children (Wirt et
a1., 1977). These questionnaires are designed to specify problem child
behaviors as perceived by the parent, usually just the mother.
Questionnaires completed by teachers and also found to be helpful in
the diagnosis of hyperactivity include the Conners Teacher Rating Scale
(1969) and the Behavior Rating Scale (Kendall and Wilcox, 1979).

Forehand and McMahon (1981, p. 25.), using a battery of parent-
completed questionnaires, describe four reasons for their use in the
research they do with noncompliant children and their parents.

Specifically, these questionnaires provide information on parental

12
perceptions of child adjustment; parental perceptions of their own
personal and marital adjustment; parental knowledge of social learning
principles; and parental satisfaction with treatment. Although often
neglected, these authors point out that it is beneficial to obtain data
from both parents to assess areas of agreement and discrepancy.

In a discussion of the abuse of parent reports in research and
clinical application, Patterson (1982), warns that the unreliability of
parent reports, with the possible exception of daily reports of
specific behaviors, may be more detrimental to the advancement of
behavioral research than they are commonly considered to be. For
example, studies have shown a tendency for parents to overestimate
treatment efficacy (Patterson and Reid, 1973). Patterson (1982)
contends that biased feedback data given from consumers to therapists
is responsible for the lack of increase in efficiency of traditional
therapies applied by well trained personnel. Hence, reliance on biased
information may be severely limiting the ability of practitioners to
improve their interventions.

I Although caution is advised when using rating scales to be filled
out by parents or teachers, such instruments have been shown to be
effective in discriminating between hyperactive and normal children as
well as in detecting treatment effects (Conners, 1973). Rating scales
are an efficient, effective means of gathering information about child
behaviors and hence are an invaluable part of a thorough assessment of
hyperactivity. However, such measures are incapable of yielding
reliable information regarding antecedent and consequent setting events
surrounding the child's behavior. This is a great limitation in terms

of the assessment and evaluation of behavioral intervention programs.

13

Previous Observation Codes

One attempt to increase the objectivity, and quantify the
behaviors of study in hyperactivity research, was an emphasis on the
measurable activity level in children. Many studies have been reported
in which movement was measured by modified self-winding wristwatches
(called actometers) (Shulman and Reisman, 1959; Johnson, 1971; Roberts
et a1., 1984). Similar instruments, pedometers, have been attached to
belts, wrists, or ankles, again as measures of bodily movement
(Barkley, 1977). Alternative measures include pneumatic floor pads to
count footsteps (Montagu and Swarbrick, 1975), motion sensitive chairs
to measure in seat movement (Barkley, 1977; Christensen and Sprague,
1973), sound wave generators to measure movement in a room (McFarland,
Peacock and Wetson, 1966), and grid-marked playrooms in which observers
or machines record the number of times the child crosses the grid
(Barkley, 1977; Routh and Schroder, 1976; Roberts et a1., 1984).

Although many of these studies were found to discriminate
hyperactive from non-hyperactive children, the utility and limitations
of such findings must be questioned. Barkley (1981a) points out some
shortcomings of such research: (1) the quantitative scores generated
show poor reliability over time, across settings, and between judges
when raters are used; (2) normative data are generally not available on
most measures; (3) the activities being measured are highly influenced
by situational factors, but the scores give few if any clues as to what
these important factors are; (4) these measures give no important
information with respect to antecedent or consequent events of the

activities measured; and (5) research has shown that these measures do

14
not correlate with parent rating scales (Barkley and Ullman, 1975).
Hence, as discussed by Barkley (19813) studies using these measures are
not evaluating the type of behaviors parents are concerned about.

Considering Barkley's (19813) view of hyperactivity as a
developmental disorder of social conduct, rule governed behavior, and
self-control, it would follow that an assessment of social interactions
should be considered essential. Barkley (19813, p. 147.) states, ”In
particular, measures of maternal commands, child compliance, maternal
contingent praise, parent and child negative behavior, and positive
interactions would appear to be of great assistance in planning
treatment and measuring improvements in response to treatment.”

According to Forehand and McMahon (1981, p. 31.) ”Direct
behavioral observation by independent, well-trained observers is the
most accepted procedure for obtaining a reliable and valid description
of current parent-child interactions.” Additionally, this procedure
allows for a measure of ”the frequency and duration of child problem
behaviors and the relationship between child and parent behaviors and,
thus, is able to quantify the problem interactions targeted for
treatment."

A review of observation methodologies by Patterson and Maerov
(1978) revealed that a narrow scope and limited scientific usefulness
were characteristic of early studies. Observational procedures
providing only such crude data as frequency counts of molar behaviors
(e.g., Olson, 1930), or judgments of trait behaviors (e.g., Gaodenough,
1930) were, as Wright (1960) pointed out, such gross descriptive data

that they allowed almost no precise hypothesis testing. The early

15
1950's provided a new look in observation methodology. Roger Barker
and his colleagues (Barker, 1951; Barker, 1968; Barker and Wright,
1954; Willems and Rausch, 1969) devised an observational system which
focused on sampling the environment as it interacted with the child.
Barker and his colleagues emphasized the collection of data relating to
macro units such as Behavior Episodes, Behavioral Setting and
Environmental Force Units (Patterson and Maerov, 1978). Although this
type of methodology led to more optimistic reviews of observational
approaches, the omnibus narrative recording involved did not produce
the specificity needed to allow for intensive study of molecular social
events (Patterson and Maerov, 1978). Shortcomings such as these
eventually contributed to the evolution of more specific data
collection systems.

The development of the Family Interaction Coding System (FICS) by
Patterson and his colleagues is an example of a recent observational
study which differs from Barker's efforts by tailoring the
observational system to test hypotheses about limited aspects of
behavior (Patterson and Maerov, 1978). The FIGS, earlier referred to
as the Behavioral Coding System (Patterson, 1977), was initially
developed in response to the limitations of available clinical
assessment instruments (Patterson and Maerov, 1978). Failure of parent
ratings, structured personality inventories and child self-report
scales to yield the specific behavioral information needed to assess
the efficacy of intervention techniques prompted Patterson and his
colleagues (Patterson, 1965) to develop this alternative assessment

method.

16

Patterson's work with the development of social engineering
procedures, first for acting-out children in the classroom (Patterson,
1965) then later for conduct disordered children in the home
(Patterson, McNeal, Hawkins and Phelps, 1967; Reid, 1967) created the
need for a data collection system designed to: (a) provide data for
continually monitoring clinical cases; (b) provide data for the
systematic assessment of family intervention outcome and (c) provide a
data base on which a theory of how aggressive behavior might be
acquired and maintained within a family could be developed (Patterson
and Maerov, 1978). Further evidence of the need for this type of
assessment procedure came when researchers began going into the home to
look for behaviors which would identify referral problems reported by
the parents. The discrepancies discovered between the interview
reports and the actual behaviors of both the parents and the children
during the home observation were commensurate with the literature
showing weak relationships between parent reports and observations of
the same behaviors made in laboratory or home settings (Honig,
Tannenbaum and Caldwell, 1968; Radke-Yarrow, 1963; Sears, 1965). The
basis for unsatisfactory parent report data seemed to be twofold
(Patterson, 1977). First of all, parents' responses to questions about
subtle behavioral relations between themselves, the problem child, and
his siblings, showed that the parents were not tracking and storing
relevant information. A second problem came with the parents' general
tendency to overestimate improvement in the deviant child's behavior
and their tendency to underestimate initial rates of deviancy (Clement

and Milne, 1967; Collins, 1966; walter and Gilmore, 1973).

17

As described by Patterson (1977) the initial task faced by the
researchers in the development of their assessment instrument was that
of compiling a preliminary item pool. The items used were specific
behaviors which were relevant to either the clinical or the theoretical
purpose of the assessment task (Patterson 1977). Clinical experience
and home observations were combined to suggest which behaviors should
be included in the observational system.

Early experiments with observational techniques were described as
chaotic but eventually served to identify 3 trial set of specific
behavioral categories. These first methods of observation, such as
recording by note-taking immediately after the observation, longhand
note-taking during the sessions, and attempts to utilize a face mask
device with a concealed microphone to record the stream of behavior as
it occurred, all eventually resulted in working definitions of the
categories as well as limitations as to which behaviors were to be
admissible within each category (Patterson, 1977). Some clinically
intuited categories, such as Aggression, were found to be too
behaviorally nonspecific for reliable coding and were broken down into
more specific behavioral instances such as Hitting, Teasing and
Destructiveness. Other behavioral categories included in the code were
Approval, Attention, Command, Command Negative, Nonrcompliance,
Physical Negative, Physical Positive, and Qork (Patterson, Reid and
' Maerov, 1978; Patterson, 1977). The end result of this early work in
developing an item pool for the Behavioral Coding System, was a set of
28 behavioral categories. The FICS eventually included an indulgence

code to make a total of 29 categories. These categories were further

18
divided into first order and second order behaviors as a guide for the
observers as to which behavior to code when more than one occur during
a single time sample (Maerov, Brummett, Patterson, and Reid, 1978;
Patterson, 1977).

Observations occurred in late afternoon, just before dinnertime,
as this portion of the day seemed to emphasize behavioral problems
(Patterson, 1977). The sessions were semi-structured, following
earlier attempts with unstructured observations which resulted in
parents and children wandering out of the observer's sight or immersing
themselves in television programs. The rules instituted during the
sessions were as follows: (1) everyone in the family must be present;
(2) no guests; (3) the family is limited to two rooms; (4) the
observers will wait only 10 minutes for all to be present in the two
rooms; (5) telephone calls: No telephone calls out; briefly answering
incoming calls; (6) no television; (7) no talking to observers while
they are coding; (8) no discussion with observers relating to problems
or their attempts to deal with these problems (Patterson et 31., 1978).

Once all members of the family were present, the observer assigned
each individual a number. The observer then alternately coded, in
sequence, the behavior of the subject and then the person(s) with whom
he interacted. The events were coded by letters referring to the
categories to which they were assigned together with the numbers
identifying the family member(s) with whom the child was interacting
(Patterson et 31., 1978; Patterson 1977).

The Family Interaction Coding System was designed to describe both

prosocial and aggressive behavior as well as the antecedents and

19
consequences which accompany them (Patterson et 31., 1978; Patterson,
1977). In addition to providing data for evaluating treatment process
and outcome (Arnold et 31., 1975; Patterson, 1974a, 1975,; Patterson,
Cobb and Ray, 1973; Patterson, Ray and Shaw, 1968; Patterson and Reid,
1973; Reid and Hendriks, 1973; Walter and Gilmore, 1973; Wiltz and
Patterson, 1974) and supporting the development and validity of a
theory of social aggression (Patterson, 1976; Patterson and Cobb, 1971,
1973; Patterson and Reid, 1970; Reid and Hendriks, 1973), the
behavioral categories could be combined in a number of different
manners to produce composite categories. The categories; Total Deviant
Behavior, Hostility, Social Aggression and Total Targeted Behavior
could all be derived from combinations of code categories. Clusters of
code categories could also be used to assess changes in parental
consequences for child behavior (Taplin and Reid, 1976), changes in the
reaction of the problem child to parental punishment (Patterson, 1976),
changes in the behavior of siblings following treatment (Arnold,
Levine, and Patterson, 1975), or family structure prior to and
following treatment.

Interobserver reliability for this system was assessed by having
every third home observation during baseline, and every fourth session
after that, coded by two observers. After the session, the percent
agreement was calculated separately for each line of the protocol. The
number of frames of agreement over the number of frames of agreement
plus the number of frames of disagreement was calculated on a line by
line basis enabling a general estimate of the quality of the data

obtained (Patterson et 31., 1978). Patterson (1977) cites the

20
percentages obtained from five different samples of observer agreement
derived from his study on his Behavioral Coding System. The percent
agreements were: 73.1%, 73.72, 80.22, 75.52, and 74.3%. In a later
work, Patterson and his colleagues claimed that a minimum reliability
standard has been set at 70%; actual figures usually range around 75%
(Patterson et 31., 1978).

The FICS provides a wealth of valuable information regarding
family interaction. Included_are such parental behaviors as Commands,
Negative Commands, Attention and Approval and such child behaviors as
Compliance, Non-compliance, Cry, and Play, in addition to other
behaviors which are not exclusive to either group. A sequential event
recording method is employed allowing for the maximum yield and quality
of information (Roberts and Forehand, 1978). The system was designed
to describe family interaction patterns between all family members,
including fathers who are often neglected in the assessment process.
For example, in a 1978 review of structured laboratory observation
studies (Hughes and Haynes, 1978), the authors discovered that only
five of the studies which they reviewed had looked at father-child
interactions.

Similarly, Wahler, House and Stambaugh II (1976), developed their
coding system after repeated disappointments with traditional
assessment techniques. Failure in both the reliability and the
validity of the available systems targeted at describing emotional and
personality problems in children (Mischel, 1968), served to involve
Wahler et al. in the movement toward direct examination of the child

within the environment where his problem behaviors occur (Tharp and

21
Wetzel, 1969; Bandura, 1969). The clinical and research literature at
the time, suggesting the practical importance of situational variables
when attempting to understand patterns of behavior (Whaler, 1969),
provided further support for the development of a new assessment
technique.

The study itself (Wahler et 31., 1976) was designed around a
subject population of male and female children, ages 4 to 14, referred
to the researchers through a variety of channels. Each child had been
assessed by other professionals and was judged sufficiently atypical to
warrant treatment. All subjects also exhibited behavior judged by
their parents and teachers as incorrigible.

Once the subjects had been identified, observers examined the
everyday content of the problem children's interactions. Detailed
observations took place in 30 minute sessions both in school and home
settings. Occurrences of the behaviors included in each category were
coded by marking a box corresponding to the specific category and
interval. The scoring procedure for ”obstruct” was the only exception
as this category was simply written on the interval row in which it
occurs.

In order to maximize the clinical utility of this code (wahler et
31., 1976), the coding system was designed to allow for restructuring
of the code for different instances. The number of behaviors included
in a specific category varied from one use of the code to another. In
some cases the categories would be identical to those on which the code
was standardized; in other cases, particular categories needed to be
narrowed in order to properly reflect the concerns expressed by the

individual parent(s) and/or teacher.

22

Nineteen behavioral categories in addition to six social event
categories are included in the observational system. The categories
were designed to describe specific aspects of the problem behaviors
which occured in the child's social environment. The 19 behavioral
categories are more generally categorized into five classes of
behavior. These five groupings include: Compliance-opposition,
Autistic, Play, Work, and Social. Two categories describing social
events (Non-aversive and Aversive Instructions) focuse on adult
behaviors which appear to be significant antecedents to many deviant
child actions. The four remaining social event categories, including
Non-aversive and Aversive Attention from adults, describe frequent
consequences of deviant and normal child behavior. Use of this system
require the coding of some actions in more than one category; the
rationale being that parents and teachers often assign more than one
value to a single action. Wahler et al. (1976) see coding the
behaviors in several categories as reflecting the multidimensionality
of the child's behavior. Various codes were scored only when the
behavior was sustained for a specified interval of time. Categories
such as Sustained Toyplay, Sustained Work and Sustained Attending were
coded in this manner. All other behaviors were scored any time they
occurred, regardless of their duration (Wahler et 31., 1976).

Wahler et al. (1976) assessed reliability by having two observers
simultaneously record the same sessions. Agreement was then computed
on an interval by interval basis. An interobserver reliability of 80%
was considered satisfactory. In general, lower reliability estimates

were obtained from home observations. wahler et al. attributed this to

23
more varied behaviors, a greater number of social exchanges and greater
freedom of movement in the home as contrasted with those aspects of
school settings.

In an effort to meet the observational needs of behavior
therapists involved in parent-child therapy, Mash et 31., (1973)
developed their Response Class-Matrix observational system.

Constructed for use in the home, clinic and classroom settings, Mash et
al. hoped their technique would also function to provide information
about which environmental stimuli were maintaining which behaviors.

As is true with the development of most systems, the Response
Class-Matrix reflectes the work of other researchers in the field.

Both Gerald Patterson and Sidney Bijou's theories and techniques for
the observation and recording of behavioral interactions are greatly
reflected in this procedure (Patterson et 31., 1969; Bijou, 1955,
1957). The impact of Constance Hanf is also present in the
reproduction of analogue parent child interactions (Hanf, 1969).

The Response Class-Matrix utilizes two coders in a live setting.
Observations generally cover 15 to 20 minutes of task accomplishment as
well as 15 minutes of free play. The procedure uses a three-term
contingency recording system in order to provide descriptive accounts
of antecedent stimuli, responses and consequent events (Mash et 31.,
1973). One of the two coders is responsible for scoring the mother's
behavior as an antecedent and the child's response to her. The other
coder records the child's behavior as an antecedent and the mother's
response as 3 consequence (Mash et 31., 1973). Father-child

interactions are not considered in this system.

24

The coders watch the interaction for 10 seconds then are signaled
by a tape recorded sound to stop observing and record for 5 seconds.
This procedure is repeated throughout the duration of the session.
Because a behavioral sampling technique is used, no effort is made to
record every response, the rationale being that the behaviors that are
recorded will, over a period of time, prove to be representative
samples of all the behaviors which occur (Mash et 31., Anderson, 1973).

The Response Class-Matrix system requires 30 to 40 hours of
observer training in order for the observers to become proficient and
reliable. Most studies using this procedure obtain at least 752
observer reliability (Mash et 31., 1973). Reliability was assessed by
evaluation of three coder pairs on their percent agreement per category
on the child's consequent behavior record. Agreement percentages,
calculated on a total of 1,078 tallies, ranged from 02 to 952 with all
but two of the five categories reaching 872 reliability. The category
with no reliability was the No Response category, but only seven total
tallies were obtained. The highest agreement percentage, 952, came in
the Interaction category. Similar results were derived for the
mothers' consequent behaviors. The agreement percentages ranged from
762 to 962 with the lowest being the Command-Question category and the
highest the No Response category (Mash et 31., 1973).

Behavior categories for the mother include: Command, Command
Question, Question, Praise, Negative, Interaction, and No Response.
The child's behaviors are categorized into Compliance, Competing
Behaviors, Independent Play, Negative, Interaction, Question, and No

Response.

25

Studies with hyperactive children in clinic analogue playroom
settings, (Barkley and Cunningham, 1979; and Cunningham and Barkley,
1979), have made use of the Response Class-Matrix to assess both the
effects of methylphenidate on mother-child interactions (Barkley and
Cunningham, 1979) and the interactions between both normal and
hyperactive children and their mothers (Cunningham and Barkley, 1979).
The results obtained from Cunningham and Barkley (1979), showed
hyperactive boys to be less compliant, less likely to remain on task
and more active than their non-hyperactive peers. Mothers were less
likely to respond positively to compliant, on task behavior, or to the
child's social interactions. Mothers of the hyperactive boys also
showed more of a tendency to impose structure and control on the
child's activities. The results of the study by Barkley and Cunningham
(1979) on the effects of methylphenidate showed an increase in the
amount of solitary play by the children, a decrease in the number of
interactions initiated by the children, and an increased responsiveness
of the mother to those interactions which were initiated. The mothers'
rewards for compliant behavior also increased while her use of
structuring commands decreased. Together, these studies indicate that
the Response Class-Matrix evidences adequate discriminent validity and
sensitivity to treatment when used with hyperactive and nonehyperactive
samples in a clinic analogue setting.

While behavioral observations in the home are expensive and time
consuming, this method is nevertheless the most widely accepted
procedure for obtaining valid descriptions of parent child interactions

in the home (Forehand and McMahon, 1981). Observations in a clinic

26
setting are also accepted although the validity of the data obtained is
questioned by some researchers (Martin, Johnson, Johanson and Wahl,
1976). In response to the ambiguity as to which method is most
reliable and affordable, Forehand, Peed, Roberts, McMahon, Griest and
Humphreys (1978) developed a system for use with non-compliant children
and their parents in both settings. The code was based on an'
observational system first developed by Hanf and King (1973).

The code categories included for parent behavior are: Rewards,
Attends, Questions, Commands (Alpha or Beta), Criticisms, Warnings and
Time Out. Categories for assessing sequential child-parent behavior
include Child Compliance, Child Nonecompliance, and Contingent-
Attention (Peed, Roberts and Forehand, 1977). Observations are
recorded sequentially in 30 second intervals, except for inappropriate
behavior, which is recorded on an occurrence only basis for each
interval (Forehand and McMahon, 1981).

The clinic observation coding procedure consists of coding the
parent-child interaction for five minutes of Parent's Games as well as
five minutes of Child's Games. Parent's games consist of a situation
where the parent is in control of the interaction and practices using
effective commands as well as time out. The Child's game is a free-
play situation where the child is the one in control. During this
game, the parent practices attending and rewarding behaviors (Peed et
al., 1977). Parent behaviors during observation are recorded in terms
of rate per minute. The percentage of parental attention contingent on
child compliance and the total number of time outs are also computed.
Child behaviors are scored then converted into percentages for later

analysis (Forehand and McMahon, 1981).

27

The application of the code in the home setting involves a trained
observer visiting the home at a time convenient for the parent. The
time chosen is typically one during which the parent reports high rates
of problem behaviors. Four sets of 40 minute observations occur prior
to and after treatment, as well as at follow up assessments. Two
observers score 252 of the sessions in order to assess reliability. A
number of procedural guidelines were formulated in an effort to
facilitate the collection of the data in the home. Some of these
include no television; no reading to the child; and preferably no
guests (Forehand and McMahon, 1981).

Although this system allows only the behavior of one parent to be
coded at a time, it is possible to code both parents by alternating
which parent is observed every five minutes.

Forehand et al. (1978) have operationally defined their
reliability level to be 802 when compared with a prescored ten minute
videotape. The reliability coefficient is computed by calculating the
number of agreements between the prescored video and the trainee
divided by the number of agreements plus disagreements. Twenty to 25
hours of training are usually required to meet this level of
reliability. Once the observer has reached this level, he is retrained
periodically throughout the duration of the study. Forehand and Peed
(1979) reported the average interobserver agreement to be 752 during
actual use of the system. Peed also claimed that the system possesses
adequate test-retest reliability and found data from repeated
observations of nonintervention parent-child interactions to be stable

and consistent (1977).

28

A number of studies done using the code have confirmed the
validity of the procedure. Forehand, King, Peed and Yoder, (1975), and
Griest, Forehand, Wells and McMahon, (1980), found significant
differences in the compliance of clinic and non-clinic referred
children. Studies done to measure significant treatment effects in
both clinic and home settings showed the instrument to be sufficiently
sensitive for use in this context (Forehand, Griest, and Wells, 1979;
Forehand, Sturgis, McMahon, Aguar, Green, Wells, and Breiner, 1979;
Humphreys, Forehand, McMahon, and Roberts, 1978; and Peed et 31.,
1977).

An observational code used to record hyperactive, off-task
classroom behaviors was originally developed by K. Daniel O'Leary
(1973) then later modified by Abikoff et 31., (1980). The coding
system, also referred to as the Stony Brook System, has been validated
in studies with normal and hyperactive children, and has proven to be
highly sensitive to the behavior differences between the two
populations.

The Stony Brook System uses 15 second interval recording
procedures and contains 14 behavioral categories rated by live
observers in a classroom setting. Except for off-task behavior, non-
compliance, out-of-seat behavior, verbalization, and daydreaming which
are scored only if they occur for more than 15 seconds, only the
initial occurrence of each type of behavior during each interval is
scored. The categories scored only by occurrence include:
Interference, Solicitation, Minor Motor Movement, Gross Motor Movement,

Threat or Verbal Aggression to Children, Threat or Verbal Aggression to

29
Teacher, and Absence of Behavior. The most frequently occurring
categories found were Interference, Off-Task Behavior, Gross Motor
Movement, Minor Motor Movements and Solicitation. The category which
discriminated most dramatically between the two populations was
Interference (disruptiveness). Over five different assessment
occasions, the Stony Brook system has shown excellent test-retest
reliability. Mean intercoder reliability has been calculated at 762
(Barkley, 1981a).

The major disadvantage with this technique, according to Barkley
(1981a), lies with its failure to identify antecedent and consequent
events surrounding the coded behaviors. In a critique by Stephen
Haynes and Robert Kerns on Abikoff, Gittleman-Klein, and Klein's
attempts to validate this behavioral observation system (1979), the
authors commended Abikoff and his colleagues for their attempts at
evaluating the system's validity. Haynes and Kerns also pointed out
that although the results of the validation study are encouraging, the
inference that the system can validly separate hyperactives from normal
children in a classroom situation must be considered in light of
various methodological shortcomings. Among these were subject,
behavior, and time-sampling errors as well as questionable content and
construct validity (Haynes and Kerns, 1979). Haynes and Kerns (1979)
found high rates of observer errors and discovered that 242 of the
interobserver agreement coefficients were below 702. For three of the
categories which significantly discriminated between groups,
interobserver agreement never passed 702. Another significant problem

was with the failure to retrain observers during the time period over

30
which the study was conducted (Haynes and Kerns, 1979), hence no
attempt to minimize observer drift was made.

It is the goal of this study to develop a coding system to
discriminate hyperactive children and their families from non-clinic
referred children and their families. The proposed coding system has
been devised not because of a lack of worthy observation instruments
reported in the literature, but because no single instrument has been
designed to assess hyperactive children and their families in a
mealtime setting.

In the development of the proposed system, much in the way of
procedure, methodology, and content has been borrowed from or based on
previous codes. For example, although many of the behaviors coded in
the FICS (Patterson, Ray, Shaw, and Cobb, 1969) and Forehand group
codes (Forehand et 31., 1978) are not applicable to this study, some of
the codes and many of the quality methodological procedures employed in
these codes have been adapted for use in the proposed system.

General issues which must be addressed when developing and
evaluating an observation coding system include deciding where, when,
and how to record behaviors. A brief rationale is offered to explain
some of the decisions made in the development of the proposed coding
system.

The home setting was chosen as it is the natural environment in
which much of the reported negative child behavior occurs. The natural
environment is also the setting in which change should ultimately occur
(Haynes, 1978). Barkley (1981a) reports that settings such as public

places, and when hyperactive children visit others, are likely to

31
produce a high frequency of problem behaviors. However, such settings
would likely be considerably more difficult to schedule and observe.
Even school or home observations may be seen as inconvenient as they
demand scheduling separate from the rest of the assessment procedure.
However, because there is some reason to doubt the validity of clinic
analogue settings (Martin et 31., 1976), the home becomes the most
practical and valid environment in which to assess parent-child
interactions.

Mealtime has been shown to be a particularly troublesome time for
behavior problem children and their families. Goodenough (1931)
discovered that child outbursts were most frequent just prior to lunch
and just prior to dinner. Barkley (19813) reports the data from two
studies using his Home Situations Questionnaire. He discovered that in
one study, 872 of the parents of hyperactive children reported that
mealtime was a problem while only 132 of normal parents reported it to
be a problem. The other study revealed that 902 of the parents of
hyperactive children found mealtime to be a problem but no normal
control sample was reported. Although many families do not always eat
together (i.e. with all members present), the setting is hardly
unnatural for most families. Inherent in the mealtime setting for most
families is a structure which, with a minimum of additional externally
imposed structure, is adequate to ensure that the family will interact,
and that the interaction will typify one which is often problematic.

A videotape recording procedure was chosen for a variety of
practical reasons. First, the videotape medium allows for the future

analysis of behaviors which may later be thought to be seen as

32

diagnostically significant. Such information would be lost with the
use of a live coding procedure if it was not looked for and gathered
originally. Second, videotapes can be stored and used for training
observers and assessing interobserver reliability at any time. Third,
most families seemed to be able to ignore the camera within a few
minutes. Many people were unaware that the camera even recorded sound
and hence, allowed themselves to speak with little apparent inhibition.
Videotapers stood out of sight during the filming which seemed to make
many people forget that they were being observed. This procedure may
have resulted in 3 decreased latency to habituation when compared with
using one or two live observers.
Selected Behavior Items and Hypotheses

Based on a review of the relevant literature, parent reports,
clinical observations, and treatment goals, target behaviors were
selected which were considered important to the understanding of how
families with hyperactive children may differ in their interaction
patterns from non-clinic families. More specifically, measures of the
quantity and quality of interaction, the frequency and clarity of
parental commands, and the frequency of child compliance were included
to provide information for the assessment and treatment of hyperactive
children. A more thorough description of the codes follows in the
methods section.

The following hypotheses were tested as part the present study:
(a) As prior studies have shown that hyperactive (Barkley, 1981a;
Cunningham and Barkley, 1979) and non-compliant clinic referred

children (Forehand, King, Peed and Yoder, 1975) evidence greater

33
conflict, receive more criticism, and have fewer positive relationships
with their family members than non-clinic referred children, it is
hypothesized that the ADD-H sample in the present study will evidence
more negative and less positive interactions with family members
compared to the nonrADD-H sample. More specifically, the ADD-H sample
will evidence 3 greater frequency of Negative Child and Other
Interactions and 3 lesser frequency of Positive Child and Other
Interactions.
(b) Given that prior studies (Barkley, 19813; Paternite, Laney and
Longhorn, 1976; Paternite, and Laney, 1980) have shown greater family
discord in the families of ADD-H children, it is hypothesized that the
ADD-H sample in the present study will evidence more negative and fewer
positive interactions among family members (excluding interactions with
the target child) compared with the non-ADD-H sample. More
specifically, the ADD-H sample will evidence 3 greater frequency of
Negative Family Interaction codes and 3 lesser frequency of Positive
Family Interaction codes compared to the nonrADD-H sample.
(c) Given that prior studies (Barkley, 1981a; Campbell, 1975) have
found that the parents of hyperactive children give more commands, it
is hypothesized that the parents in the ADD-H sample in the present
study will give more good quality and poor quality commands than
parents without hyperactive children. More specifically it is
predicted that the ADD-H sample will evidence a greater frequency of
the Alpha Command and Beta Command codes compared to the non-ADD-H

sample.

34
(d) Given that non-compliance is one of the primary reasons for the
referral of hyperactive children to psychological clinics (Barkley,
19813), and that earlier studies (Barkley, 19813, Cunningham and
Barkley, 1979; Campbell, 1975) have indicated that hyperactive children
do exhibit less compliance to parental commands, it is hypothesized
that the ADD-H children in the present study will comply less often to
parental commands than the non-ADD-H children. More specifically the
ADD-H sample will evidence a greater frequency of the Non-compliance
behavior code and a lesser frequency of the Compliance behavior code in
response to parental commands compared with the non-ADD-H sample.
(e) Based on the research findings indicating greater levels of
parental psychopathology, depression, hysteria and marital
dissatisfaction among the parents of hyperactive children (Barkley,
19813, Cantwell, 1972) and studies suggesting a lack of parental
positive responding to behavior problem children (Bell, 1968; Bell and
Harper, 1977), it is hypothesized that the parents of ADD-H children in
the present study will use positive statements less often than non-
ADD-H parents. More specifically, the ADD-H sample will evidence a
lesser frequency of the Parent Positive Statements code than the non-
ADD-H sample.
(f) Given that previous studies (Barkley, 19813; Amery, Minichiello,
and Brown, 1984) have indicated that aggression and negative behaviors
are more common in hyperactive children than non-hyperactive children,
it is hypothesized that the ADD-H children in the present study will
exhibit more negative, aggressive or inappropriate behaviors than the

non-ADD-H children. Therefore, the ADD-H sample will exhibit a higher

35
frequency of behaviors coded as Inappropriate than the non-ADD-H
sample.
(g) Based on earlier classroom studies indicating greater out of seat
behavior in hyperactive children (Barkley, 1981a; Abikoff, Gittelman-
Klein and Klein, 1978; Abikoff et 31., 1980), it is hypothesized that
hyperactive children in the present study will leave their seats more
often than non-hyperactive children. More specifically, the ADD-H
sample will evidence a greater frequency of the Out of Seat code

compared to the non-ADD-H sample.

36

Chapter 3

Method
Subjects

The subjects were 41 school-age children who were assessed and

found appropriate for the Child Behavior Project, a treatment program
for hyperactive children at Michigan State University's Psychological
Clinic. Inclusion criteria were (1) age between 7 and 11.5 years; (2)
a score of 15 or more (two standard deviations above published means)
on the Hyperactivity index of the Conners Parent Questionnaire; (3) the
absence of gross physical impairments, intellectual deficits of
psychosis in either the child or the parent(s); and (4) the identified
problem child was not currently receiving medication for control of
his/her hyperactivity. A group of 18 normal control subjects were also

included, equated for IQ, grade level and age.

Procedure and Study Design_

The data were gathered as part of a treatment program (The Child
Behavior Project) designed to assess the potential additive effects of
two commonly used methods of treatment for hyperactive children. The
methods under study were behavioral parent training (e.g. Barkley,
1981; Forehand, 1977; Patterson, 1974), and instruction in self-control
techniques (e.g. Michenbaum, 1977; Kendall and Braswell, 1985).
Although both of these treatments have demonstrated therapeutic value
during the intervention process, neither treatment alone has been found
to produce significant generalization and maintenance of treatment

effects (Barkley and Cunningham, 1978; O'Dell, 1974; Phillips and Ray,

36

37
1980). It has been hypothesized by researchers from the Child Behavior
Project that the combination of treatments would provide maximal
benefit by altering those contingencies in the home environment
maintaining maladaptive behavior patterns while also helping the child
develop specific adaptive behavioral skills.

As part of the requirement for participation in the Child Behavior
Project, the parent(s) filled out an extensive battery of
questionnaires, including behavior checklists, and developmental and
family history questionnaires. An assessment battery was administered
to the target child by trained undergraduates or graduate students from
a Clinical Psychology program. All testers were blind to diagnostic
group (i.e hyperactive vs. normal) and treatment status (i.e pre-test,
post-test or follow—up). Included were various self-report measures,
academic achievement and IQ screening measures, and measures of
impulsivity and distractibility. These parent and child assessments
were completed before and after a 12 week treatment program and at 3
six month follow-up.

In addition to the pencil and paper assessment measures, families
were expected to allow a member of the project to videotape them in
their home for 20 minutes during 3 mealtime. Video tapings were
conducted pre and post-treatment and again at the six month follow-up.
A total of 54 hyperactive families were available at pretaping from the
treatment groups and 20 from the control group. From these, videotapes
of 41 families were selected for analysis. Videotape data from 13
families were excluded due to either malfunctions in the tapes or

attrition during the later phases of the study, such that neither a

38
post or follow-up videotape was available. The inclusion of only
videotapes for which either a post, or follow-up tape was available was
to allow for further analysis of treatment effects on this sample in 3
future study. Although tapes from all 20 control families were
available for analysis, two children were excluded from the control
sample, as behavior checklists completed by teachers indicated that the
children evidenced significant behavioral problems. It seems likely
that the parents of the two excluded children were seeking a cost-free
assessment and hence misrepresented their child's behaviors.

The parent(s) were informed during an early contact with the
families that the purpose of the videotapes was to aid the researchers
in evaluating the treatment program and that the tapes would not be
seen by persons outside of the Child Behavior Project. Families were
later phoned by a graduate student member of the project to select a
convenient date and time for the family to be videotaped. A graduate
or undergraduate student videotaper, who was familiar with the
videotape cameras used in the project, was sent to the home of the
family to do the taping. Equipment set up instructions are provided in
Appendix C. Videotapers were instructed to be as unobtrusive as
possible. These procedural instructions are provided in Appendix C.
Briefly, videotapers were instructed to introduce themselves, state
their purpose in being there, ask where to set up the equipment, tape
for 20 minutes, thank the family, and leave. Videotapers were not
permitted to accept food from the families or to allow the family to

discuss problems with them.

39

Design of the Code

Information from previous codes (Forehand and McMahon, 1981;
Abikoff et 31., 1977; Abikoff et 31., 1980; Patterson et 31., 1969;
Wahler et 31., 1976; Mash et 31., 1973), direct observation of
hyperactive children and their families during mealtime, readings of
clinical descriptions, as well as much discussion with experienced
practitioners, led to the initial item pool. It was decided that the
code should be able to evaluate sequences of behavior between the
hyperactive child and the child's family. Of primary interest is the
interaction between the child and his parents, as this is often the
juncture of much conflict and often a primary reason for the referral.

The Hyperactivity Coding System is designed to describe patterns
of family interactions during a 20 minute, home based, meal-time
setting. As it is a behaviorally based system, only observations of
overt behaviors are measured. It is the aim of this system to quantify
the occurrences of selected target behaviors. The primary purpose of
the code is as a research instrument to discriminate patterns of
behavior associated with hyperactive children and their families from
non-clinic referred children and their families. A further study will
focus on the validity of the code to assess the efficacy of different
treatment designs. The code should also offer practical utility as an
assessment tool for clinicians. However, the code is inclusive and
complex enough as to require the use of videotape recording and could

not be used effectively in a live observation setting.

4O

Coding Procedure and Development of the Code

Once a videotape recording of the family had been made it was
divided into continuous 10 second intervals. This was done with the
addition of a voice track, counting ten second intervals, mixed on to
the videotape. To accomplish this, a new videotape was created
containing the audio and video portions of the original tape combined
with another audio track containing the interval designations. This
procedure was titled Sound on Sound and was performed primarily by an
advanced undergraduate student member of the project. The procedure is
further explained in Appendix C.

The Sound on Sound tape was designed to be coded in two separate
viewings. This procedure was adopted to allow the coder to focus on
only a limited quantity of behaviors during each viewing. Each passage
through the tape was coded on 3 corresponding coding sheet. The
scoring sheets were specifically designed to code the sequences of
behavior to be focused on during the particular viewing. The coding
sheets are found in Appendix D.

As a means of expediting and improving the reliability of the
coding procedure, prior to coding, each videotape was completely
transcribed by undergraduate members of the project. The students were
instructed to write down, verbatim, what each person in the family
stated and in what interval it was stated. The students were also
requested to play difficult passages over repeatedly, as necessary, to
extract as much verbal content from the tape as possible. These
transcription sheets were used by all coders for the first passage

through the tape.

41

The tapes were later retranscribed for the second passage through
the tape by a pair of trained coders focusing on parental commands.
This retranscribing procedure was performed because many of the initial
transcriptions were found to be missing key verbal information
necessary for this coding procedure. Only information which both
transcriber/coders decided were commands addressed to the target child
were retranscribed along with any verbal responses made by the child.
The transcriber/coders were then not permitted to code tapes which they
had transcribed. This prevented them from scoring videotapes which
they had previously observed and discussed with another coder.

For the first passage, titled Interaction/Inappropriate/Positive,
an interval recording technique was utilized such that the occurrence
of a particular behavior within a ten second interval or the global
qualitative rating for the interval, dictated the scoring for that
entire interval. With this method, only one occurrence of a behavior
is scored regardless of whether more occurrences take place within the
interval. On this passage, the coder made two global ratings for the
family interactions. One code was 3 measure of the quality of
Interaction between the Child and Others while the other code was a
measure of Family Interaction, exclusive of the target child, for the
10 second interval. The coder was also instructed to make 3 check for
each interval upon the occurrence of child Out of Seat, child Self-
stimulation behavior, Inappropriate child behaviors as well as Positive
Statements by the parents. Adequate reliability (702 calculated by the
effective percent agreement method) was achieved during training for
all but the Self-stimulation code. Hence, only the Self-stimulation

code was excluded from the coding procedure.

42

During the second passage through the tape, titled the Parent to
Child passage, the coder was asked to focus only on behavior sequences
that were initiated by a parent and were directed toward the target
child. An event recording procedure was used to record every instance
of a selected behavior, and note what interval it occurred in. The
selected behaviors for this passage include good (Alpha) and poor
(Beta) commands by parents and 3 rating of the child's Compliance to

the parental commands (Compliance, or Non-compliance).

Item Selection

Items selected for the code were done so as to allow for the
description of specific behaviors or interaction patterns thought to be
relevant for discriminating hyperactive children and their families
from control children and their families and possibly for assessing
treatment effects as well. General requirements of the coding system
were that it be capable of measuring some level of child gross motor
activity, frequency of inappropriate behaviors, frequency and quality
of interactions between family members, types of parental commands and
responses to them, and parental use of positive reinforcement. General
definitions and examples of the codes are listed below. For more

thorough definitions and examples see Appendix B.

Interaction/InapprOpriate/Positive
Interaction (Positive, Neutral, or Negative)
This is an interval recording measure of the general affect and

quality of a ten second interval coded for the interaction between the

43
child and others and again separately for the family excluding the

target child.

Out of seat

 

This is an interval recorded, general measure of gross motor
movement, e.g., child stands up, or leans on table so that both

buttocks are not on the chair.

Inappropriate child behavior

 

This is an interval recording measure of the frequency of negative
child behaviors, e.g., child whines, yells, uses physical aggression,

deviant talk or humiliates another person.

Positive statements

This is an interval recording measure of the frequency of positive
or reinforcing statements used by the parents. For example, any time 3
parent praises or thanks the child for his past, present, or future

behavior.

Parent to Child
Command (Alpha, Beta)
This is an event recording measure of how often a child is
instructed to perform a behavior and the quality (alpha or beta) of the
instruction given to the child, e.g., parent instructs the child to

stop playing with his food, or to behave himself.

44
Alpha command: 3 good quality command, rule, directive question, or
suggestion to which only one specific verbal or motoric response is
appropriate and feasible. Included are Labeled commands which have 3
clearly specified objective leaving no doubt as to what the child is
supposed to do, Stop commands which instruct 3 child to cease an
ongoing behavior or one that is about to take place, and Question
commands which resemble the above Alpha commands but are stated in a
question form.
Examples:

”Finish your meat before you drink your soda." (Labeled command)

”Stop kicking your chair.” (Stop command)

Also scored under the Alpha command category are General
Contingency Statements which resemble the above Alpha commands but
contain statements indicating contingencies or consequences related to
the child's behavior and Permission and Rule statements which are
general rules that specify a behavior to be initiated or inhibited.
Examples:

”If you don't stop interrupting me when I am talking, you will not

get dessert tonight.” (Contingency statement)

"We use forks to eat our spaghetti, not our hands." (Rule

statement)

Beta command: a poor quality command to which compliance is difficult
or impossible. Included are Vague commands, which lack 3 clear
direction; Chain commands, which are a series of logically related

commands with less than five seconds separating them; and Repeated

45
commands, in which the same command or a similar version of the command
is issued within five seconds.
Examples:
”Now just be good." (Vague command)
"Sit down, face forward, and start eating." (Chain command)
"Drink your milk (less than five second pause), come on now

drink your milk." (Repeated command)

Child responses to parental commands (Compliance or Nonrcompliance)
This is an event recording scale of the child's compliance, or failure
to comply to 3 parental command, e.g., child is told to sit-up and eat
his food, and does so or, sits-up but does not eat, or completely

disregards the command.

Compliance: the child obeys, complies with a parental command within
five seconds of the offset of the command. This includes appropriate
verbalization or motoric response to the command. In the case of a
Chain Command, the child must comply to all the directives contained in.
the command within five seconds of the completion of the command. This
code is not used as a response to a vague command, as compliance is

impossible due to the nature of the command.

Non-compliance: the child refuses to comply or does not respond to a
parental command within five seconds after the offset of the command.
This code is used if either the child fails to initiate compliance

within five seconds, fails to maintain inhibition of a prohibited

46
response for five seconds, or fails to comply to all directives within
a Chain Command.

Training Coders

 

Coders were blind to both subject status (i.e. hyperactive vs
control) and treatment status (i.e. pre vs post). Although only
pretest data were used in the analysis to discriminate the hyperactive
group from the controls, post data were also included in the
reliability assessment to increase the number of comparisons for this
analysis. There were approximately 25 undergraduate coders, receiving
independent study credit through the psychology department at Michigan
State University. The majority of the coders were psychology majors
while others were pursuing different fields such as pre-medicine and
business.

Two groups of coders were trained for the
Interaction/Inappropriate/P031tive codes using a similar procedure,
with the differences outlined below. For both groups, the author
trained and supervised the coders, holding two hour training sessions,
three times weekly. At the first training session, the rationale for
using direct observation, and this code specifically, were explained to
the undergraduate participants. The students were asked to read the
code thoroughly by the next session. The following training session
was spent discussing the code in depth while the remainder of the
training sessions were spent viewing the videotapes, coding them, and
discussing any shortcomings of the code as they presented themselves.
Two quizzes were also given during the training process to assess the

coders' progress.

47

The first group of coders trained were instrumental in helping the
author to modify and further develop the section of the code which they
were trained to use. During the majority of the training sessions, the
coders and the author viewed 20 minute videotapes of the subjects and
their families at mealtime. As new behaviors were observed that the
code could not adequately categorize, discussions were held and the
author decided how to best modify the code. The two hour training
sessions were held three times weekly for seven weeks followed by three
weeks of only one, two hour meeting per week, with the remainder of the
time spent by the coders in individual coding sessions. Codings,
completed individually, from tapes which were excluded from the data
set, were used to assess interobserver reliability, and as guides
toward further modification of the code and/or further training of low
reliability sections of the code. Reliability was scored by the
effective percent agreement method (Haynes, 1978; Jensen, 1959). For
this method, the number of agreements of the occurrence of a behavior
are divided by the total number of agreements of occurrence plus
disagreements of occurrence X 100. Feedback was given to each observer
in a group setting throughout the last three weeks of the training.

After a two week vacation, the previously trained coders returned,
and went through three weeks of re-training along with 3 group of new
observers who were just beginning training. These sessions served not
only to re-train and increase practice with the code, but to model the
use of the code for the new coders. This second group of coders
received only five weeks of training before coding on their own, as the

code had been improved considerably and was much easier to teach.

48
Other than the differences mentioned above, and the fact that only one
quiz was given to the second group, the procedure for training the
second group of coders was the same as that for the first group.

Upon the completion of the coding for the
Interaction/Inappropriate[Positive passage, an additional independent
group of coders was trained following the same basic training procedure
outlined above. Approximately eight weeks were spent training the new
coders and modifying the Parent to Child, and Child Response to
Parental Commands sections of the code before adequate interobserver
reliability was reached and the actual coding of the videotapes
commenced.

One or two weekly retraining sessions continued throughout the
actual coding periods. Tapes which were coded by two or more people
independently, were selected for viewing during the group training
sessions to continually assess the reliability and accuracy of the
coded data. Areas of disagreement were discussed among the group and
feedback was given to the individuals whose codings were being
reviewed. Previously coded criterion tapes were also reviewed to help
check on and minimize observer drift. Only one coder consistently
failed to achieve reliability with the other coders and data from this
individual were excluded from the analysis.

Data Analysis

Initially, interobserver reliability was assessed for all of the
behavioral codes. Then Pearson product-moment correlations between all
variables were computed (Appendix A). This analysis allowed for the

assessment of intercorrelations between the behavioral codes,

49
correlations of the behavioral codes with significant demographic
variables, and the correlation of the behavioral codes with the
caretaker checklists. Two-tailed t-tests or chi-square tests were also
carried out to detect significant differences between the hyperactive
and control groups on all pertinent demographic variables and
behavioral codes. Because a significant sex difference was found
between the two groups, a two (group) by two (sex) multiple analysis of
variance (MANOVA), followed by univariate analysis of variance (ANOVA)
was computed for all behavioral codes to test for main effects for

diagnostic group and sex, and to test for group by sex interactions.

Chapter 4

Results

Reliability

Table 1 presents a list of the variables and their corresponding
abbreviations. These abbreviations will be used throughout the study.

Interobserver reliability for each of the codes was calculated by
two different methods: (1) The effective percent agreement (Jensen,
1959), calculated by the formula (the number of agreements/the number
of agreements + the number of disagreements) X 100, where only those
occasions in which either or both observers rate the target behavior as
having occurred are scored, and (2) Cohen's Kappa (1960) calculated by
the formula (Po-Pc)/(1-Pc), where Po is the proportion of observed
agreements and Pc is the proportion of chance agreements (Hartman,
1977).

For the effective percent agreement calculations, reliabilities
were scored for the larger categories (Child and Other Interaction,
Family Interaction, Commands, and Compliance) such that agreement was
scored if both coders agreed (1) that a scorable behavior occurred; (2)
on the qualitative nature of the behavior where appropriate (Positive,
Neutral, Negative, Alpha, Beta) and (3) the interval in which the
behavior occurred. For the Cohen's Kappa analysis, the larger code
categories were sub-typed into their component categories (Positive,
Negative, Neutral, Alpha, Beta, Compliance, Nonrcompliance, and Off-
Camera). Unlike effective percent agreement, Cohen's Kappa allows for
the consideration of interobserver agreement when both coders agree
that a behavior did not occur. However, Cohen's Kappa does yield a
proportion agreement score that is corrected for chance agreements.

50

Table 1

51

List of all variables and their abbreviations.

 

 

Sex

Age
Grade
PPVT 2
PPVT IQ

Mother Conners -
Teacher Conners -

Total C60 Int -
Positive C&O Int -
Neutral C&O Int -
Negative C80 Int -

Total Family Int
Positive Family Int-
Neutral Family Int -
Negative Family Int-

Peabody Picture Vocabulary Test (PPVT) percentile
Peabody Picture Vocabulary Test (PPVT) standard

score

Mother's rating on Conners hyperactivity index
Teacher's rating on Conners hyperactivity index
PIC-R Family Relations Scale - Mother's rating on the Personality
Inventory for Children Revised (PIC-R) family
relations scale

Total
Total
Total
Total
Total
Total
Total
Total
Total
Total

Total
Total
Total
Total
Total
Total

Inappropriate -
Out of Seat -
Parent Positive Statements
Intervals -
Total Commands -
Alpha Commands -
Beta Commands -
Compliance -
Non-Compliance -
Off-Camera -

Total

Child and Other Interaction

Child and Other Positive Interaction
Child and Other Neutral Interaction
Child and Other Negative Interaction
Family Interaction

Positive Family Interaction

Neutral Family Interaction

Negative Family Interaction
Inappropriate Child Behaviors

Out of Seat

- Total Parent to Child Positive Statements
Intervals

Commands

Alpha Commands

Beta Commands

Compliance to commands
Non-compliance to commands
Off-camera following commands

52

Table 2 presents the mean reliability coefficients, and the range
of reliability scores for all of the behavioral codes as assessed using
the effective percent agreement method. Coefficients calculated by the
effective percent agreement method indicated that satisfactory
reliabilities were achieved for the Child and Other Interaction
Category, Family Interaction Category, and Command and Compliance
codes, using 3 minimum reliability standard of 702 (Patterson et 31.,
1978). Out of Seat was only marginally below the criterion level while
Inappropriate, and Parent to Child Positive Statements were moderately
to considerably lower respectively.

The Cohen's Kappa reliability coefficients are shown in Table 3.
Reliability coefficients for Child and Other Interaction were 332 for
Positive, 712 for Neutral and 132 for Negative. Family Interaction
reliabilities were 302 for Positive, 662 for Neutral and 62 for
Negative. Inappropriate, Out of Seat, and Parent to Child Positive
Statements were: 62, 492, and 132 respectively. The Command
reliabilities were 722 for Alpha Commands and 612 for Beta Commands.
The compliance coefficients were 632 for Compliance, 612 for Non-
compliance and 162 for Off-Camera.

Intercorrelations Among Behavioral Codes

Pearson product-moment correlations were computed to determine the
degree of independence and interdependence of the behavioral codes. Of
the 136 correlations calculated (see Appendix A), 71 correlations
between the behavioral codes were found to be significant at the pfi.05
level of significance. However, only nine of the significant

correlations reached a value of r2360. Correlations of this value

53

Table 2

Effective percent agreement mean reliability coefficients, and range of
reliability scores for all behavioral codes.

Cases with Range of
Behavior code Mean Percent Agreement Occurrence* Scores

 

 

'fi

Child and Other

Interaction category 782 36 53-942
Family Interaction

Category 732 31 49-902
Inappropriate 172 11 0-1002
Out of Seat 622 27 0-1002
Parent Positive Statements 442 10 O-1002
Command Category 802 69 0-1002
Compliance Category 782 69 0-1002

 

Note. Analyses based on n - 72 tapes for Command and Compliance
Categories and 8640 intervals. All other analyses based on 36 tapes
and 4320 intervals.

* The number of cases in which at least one occurrence of the behavior
was reported. Each case equals approximately 120 intervals.

Table 3

Cohen's Kappa mean reliability coefficients, and range of reliability

scores for all behavioral codes.

 

 

 

Range of
Behavior code Mean Kappa Sggggg
Positive C80 Int 332 -2-1002
Neutral C60 Int 712 -6~962
Negative C&O Int 132 0-1002
Positive Family Int 302 -l-1002
Neutral Family Int 662 34-1002
Negative Family Int 62 0-1002
Inappropriate 62 0-1002
Out of Seat 492 0-1002
Positive Parent Statements 132 0-100
Alpha Commands 722 0-1002
Beta Commands 612 0-1002
Compliance 632 -2-1002
Non-compliance 612 -1-lOO2
Off-Camera 162 0-1002

 

Note. Analyses based on n - 72 tapes and 8640 intervals for Alpha
Commands, Beta Commands, Compliance, Non-compliance and Off-Camera.

All other analyses based on 36 tapes and 4320 intervals.

55
would suggest that the two codes are yielding approximately the same
information in that they share at least 362 of their variance.

Table 4 lists the nine correlations between the behavioral codes
of .60 or greater. Correlations indicating interdependence between
codes were found for only those codes which by definition had to co-
occur (eg. Total Commands with Compliance and Non-compliance), or for
those codes in which the behaviors from one code comprised a subset of
the other (eg. Total commands with Alpha or Beta commands). All other
codes which did not meet either of the above descriptions were found to
produce essentially non-redundant information.

Analysis of the Demographic Variables

Table 5 presents the means and standard deviations for the
demographic variables by groups. An overall significant difference
between the groups was found for Sex only x2(1, Nf59) - 5.30,‘pfi.02
with the ADD-H group having 34 boys and 7 girls, and the control group
having 9 of each sex. The higher representation of males in the
hyperactive sample is close to the generally accepted sex ratio for
this population, of 6:1 in favor of males (Barkley, 19813).
Nonetheless, in subsequent analyses of differences in the behavioral
codes between ADD and non-ADD-H subjects, a 2 X 2 MANOVA and 2 X 2
ANOVAs were performed rather than t-tests in order to assess for the

possible influence of sex of subject.

56

 

 

Table 4

Intercorrelations Among Behavioral Observation Codes of r>.60.
Behavioral Codes Correlation
1. Total Commands/Compliance .62:

2. Total Commands/Non-Compliance .87*

3. Alpha Commands/Compliance .75*

4. Beta Commands/Non-compliance .91*

5. Total Commands/Alpha Commands .85*

6. Total Commands/Beta Commands .92*

7. C80 To Int/Neutral C80 Int .93*

8. Family To Int/Family Nu Int .97*

9. C80 Ng Int/Inappropriate .61

 

*p < .05.

57
Construct Validity

Construct validity of the behavioral codes was assessed in two
ways. First, the behavioral observation codes were correlated with the
Conners Teacher Rating Scale, the Conners Parent Rating Scale, and the
PIC-R Family Relations Scale (see Appendix E for checklists) to
determine the degree of covariation between each of the codes and
scores on these caretaker checklists of child behavior.

Second, a Multivariate Analysis of Variance with all of the
behavioral observation codes serving as dependent measures was
performed to assess the main effects and interaction of diagnostic
group and sex. A marginally significant (F-1.57,'pfi.13) main effect
for diagnostic group was found, while no significant main effect was
found for sex (F-1.18, p$.33), or for the diagnostic group X sex
interaction (F-.92, p$.55). As the power of the MANOVA was low due to
the inadequate reliability of some of the codes and the small number of
subjects included in the study, the marginally significant effect of
diagnostic group was accepted as a valid indicator of an overall group
difference for the combined codes. Then, 3 series of 2 x 2 (diagnostic
group X sex) ANOVAs were computed for each of the behavioral codes in
order to determine how well each of the codes discriminated between ADD
and non-ADD-H children and their families.

The correlations between the behavior observation codes and the
behavior checklists are shown in Table 6, and the results of the ANOVAs
are shown in Tables 7-11. These tables will be discussed as they

relate to the major hypotheses in the study.

58

Child and Other

 

It was hypothesized that the caretaker checklists would negatively
correlate with the Child and Other Positive Interaction code, and
positively correlate with the Child and Other Negative Interaction
code. It was also hypothesized that there would be a higher frequency
of Positive Child and Other Interaction in the control group and 3
higher frequency of Negative Child and Other Interaction in the
hyperactive group.

Table 6 shows that no significant correlations were found between
any of the Child and Other Interaction codes and the checklists. This
suggests that the observed quality and/or frequency of interaction
between the target child and other family members during mealtime is
unrelated to either the mother's or teacher's perceptions of the
child's hyperactive behaviors, or the mother's perception of the
quality of the family's interactions.

Table 7 indicates that for the Child and Other Interaction
variables (Total, Positive, Neutral, Negative) 3 significant group
difference was found for the Negative Interaction scale [F(1,58) -
4.01, pfi.05] with approximately four times as many occurrences in the
hyperactive group than in the control group (see Appendix A for group
means and standard deviations). No group differences were found for
the Total, Positive or Neutral Interaction scales.

These findings indicate that although none of the Child and Other
Interaction codes correlated significantly with the construct validity

measures, the Negative code did discriminate between the two groups in

59

Table 5
Means and standard deviations for sex, age, grade and the PPVT standard
score for hyperactive (N - 41) and control (N - 18).

 

 

Test of
Hyperactive Control
Siggificance
Sex (Mel, F-2)
2 a
Mean 1.17 1.50 x - 5.3
SD .38 .51
Grade
Mean 3.02 3.44 x2 - 7.1
SD 1.94 1.38
Age
SD 1.82 1.39
PPVT IQ
Mean 107.98 109.78 t - -.41
SD 14.88 16.56

 

Note. df-l for sex chi-square and df-6 for grade chi-square. Df-57 for
all t-tests.
*- £<0050

60

the expected direction. The positive and neutral interaction patterns
between the target child and other family members were not found to be
significantly different between the two groups.
Family
It was hypothesized that the checklists would negatively correlate with
Positive Family Interaction, and positively correlate with Negative
Family Interaction. It was also hypothesized that there would be a
higher frequency of Positive Family Interaction in the control group
and a higher frequency of Negative Family Interaction in the
hyperactive group.

Table 6 shows that the Mother Conners' Hyperactivity Index scores
were negatively correlated with Total Family Interaction [r-.32,
p$.006], Positive Family Interaction [r-.26 .pK.03], and Neutral
Family Interaction [r-.28 ‘pfi.02]. The Teacher Conners was also
negatively correlated with Total Family Interaction [r--.26,'2K.02],
Positive Family Interaction [r--.26,‘p§.02], and tended toward a
significant correlation with Neutral Family Interaction [r--.21,
p$.06]. The PIC-R Family Relations Scale was negatively correlated
with the Neutral Family Interaction scale [r--.28, pfi.04].

These results indicate that a higher score on the Mother Conners
(greater severity of hyperactive symptomotology) was correlated with
less Family Interaction, of both the Positive and Neutral type. A
higher score on the Teacher Conners was also negatively correlated with
Positive Family Interaction and tended toward significance with Neutral
Family Interaction. A higher score on the PIC-R Family Relations Scale
(more problems) was also associated with a lower level of Neutral

Family Interaction.

61

Table 6

Correlation coefficients and significance levels for all codes with

Mother Conners, Teacher Conners and the PIC-R Family Relations Scale.
Total Pas. Neu. Neg. Total Pos.
C80 C80 C80 C80 Family Family Family Family Inappro-

Neu.

Neg.

 

 

 

Int Int Int Int Int Int Int Int priate
Mother * *
comers 010 -007 015 -008 -032 -026 -028 008 .11
Teacher *
comers 015 -012 017 004 -026 -026 -021 -006 012
Pic-R
Family
Ralations *
scale 006 -001 002 018 -023 013 -028 019 00001
Parent
Pas. Total Alpha Beta None
Out of State- Inter- Com- Come Come Compli- Compli- Off-
Seat ments vals mands mands mands ance ance Camera
Mother * * * *
comers-0007 -008 -013 035 038 026 024 029 .14
Teacher * * * *
Conners-.12 .03 -.O6 .28 .29 .21 .11 .31 .004
Pic-R
Family
Ralations * * *
scale 009 ‘010 -014 026 018 028 013 026 011
Table 7
F-statistics for Child and Other Interaction variables.
Total Positive Neutral Negative
C80 Int C80 Int C80 Int C80 Int
*
Group .001 .74 .02 4.01
Sex .77 .02 1.36 1.46
Group x Sex .16 .61 .66 .73
Error (.022) (.002) (.022) (.001)

 

Note. df - 1,58 for all F-statistics.
*2 < .05.

 

 

w———- g-:§:—:._.:'._..'_‘=_

62

As shown in Table 8, there were significant between group
differences for Total Family Interaction [F(1,58) - 5.99, 2‘ .02], and
Positive Family Interaction [F(1,58) - 6.69 2‘ .01]. Neutral Family
Interaction tended toward statistical significance [F(1,58) - 3°78:.2‘
.06] with higher frequencies of all of these behaviors in the control
group. No significant group difference was found for the Negative
Family Interaction variable.

In agreement with the results from the correlations between the
checklists and the Family Interaction codes, the F-tests indicate that
the Total and Positive Family Interaction codes discriminated between
the hyperactive 3nd non-hyperactive children and their families. It
appears that when being observed in the home during mealtime, families
with hyperactive children engage in less positive and total interaction
than families without hyperactive children.

Command/Compliance

It was hypothesized that the checklists would positively correlate with
Total Commands, Alpha Commands, Beta Commands, and Non-compliance and
that there would be 3 higher frequency of the three Command categories
and Non-compliance in the hyperactive condition.

Table 6 shows that the three checklists were found to correlate
with most of the Command/Compliance codes. Table 6 shows that the
Mother Conners was positively correlated with Total Commands [r-.35,
p$.003], Alpha Commands [r-.38,.pfi.002], Beta Commands [r-.26, p§.02],
Compliance [r-.24,lpfl.03], and Nonrcompliance [r-.29, pfi.Ol]. The
Teacher Conners was positively correlated with Total Commands [r-.28,

.p$.02], Alpha Commands [r¥.29,.p$.01], Beta

63

Table 8

F-statistics for Family Interaction variables.

 

 

 

 

 

 

Total Positive Neutral Negative
Family Int Family Int Family Int Family Int
Group 5.99* 6.69* 3.78 1.01
Sex .47 .O7 .37 .66
Group x Sex .70 .50 .59 2.20
Error (.06) (.004) (.054) (.0001)

 

Note. df - 1,58 for all F-statistics.
*p_ < .05.

64
Commands [r-.21, pfl.05], and Nonrcompliance [r-.31,‘p$.01]. The PIC-R
Family Relations Scale was positively correlated with Total Commands
[r-.26, pfi.05], Beta Commands [r-.28, pfi.04], and Non-compliance
[r-.26, pfi.05]. Hence, children with higher Conners scores are more
likely to receive both Alpha and Beta commands, and to not comply with
them than are children with lower Conners scores.

The PIC-R Family Relations Scale correlated positively with Total
Commands, Beta Commands and Non-compliance, but failed to correlate
with Alpha Commands. This indicates that parents in families in which
the mother reports greater discord are likely to give more Total
Commands, especially Beta commands, and these are more likely to be
responded to with non-compliance.

The analysis in Tables 9 and 10 indicate that significant
differences occurred between the hyperactive and control groups on
Total Commands [F(1,58) - 6.11, p$.02], Alpha Commands [F(1,58) - 4.67,
p$.04], Beta Commands [F(1,58) - 4.79, p$.03], and Non-compliance
[F(1,58) - 6.03, pfi.02], with the ADD-H group receiving more commands
and responding with more non-compliance compared to non-ADD-H children.
Parent to Child Positive Statements
It was hypothesized that the checklists would negatively correlate with
Parent to Child Positive Statements. It was also hypothesized that
there would be a higher frequency of Parent to Child Positive
Statements in the control condition.

Table 6 indicates that the Parent Positive Statements code failed
to correlate significantly with any of the checklists. Similarly, the

results found in Table 11 indicate that there were also no differences

65
between the groups on this code. As pointed out earlier, this code was
found to occur very infrequently and suffered from low reliability.
However, a significant Group x Sex interaction [F(1,58) - 4.09, pf.05]
was found for the Parent Positive Statements code with the highest
occurrence of this behavior in the male, nonrADD-H group.

Inappropriate

 

It was hypothesized that the checklists would positively correlate with
Total Inappropriate behavior. It was also hypothesized that there
would be a higher frequency of Total Inappropriate behavior in the ADD-
H group.

Table 6 shows that the Inappropriate behavior code failed to
correlate significantly with any of the checklists. Similarly as shown
in Table 11, there was no significant difference between the groups on
this code. However, there were no occurrences of inappropriate
behavior in the non-ADD-H group. The data indicate a trend toward a
group difference [F(1,58) - 3.26, p§.08), with low frequency
occurrences of Inappropriate behavior in the ADD-H group only.

Out of Seat

It was hypothesized that the checklists would positively correlate with
Out of Seat behavior. It was also hypothesized that there would be a
higher frequency of Out of Seat behavior in the hyperactive condition.

Table 6 shows that the Out of Seat behavior code failed to
correlate significantly with any of the checklists. Similarly, as
shown in Table 11, the code failed to discriminate between the ADD-H

and non-ADD-H groups.

Table 9

66

F-statistics for Command variables.

 

 

 

 

 

 

 

 

Total Alpha Beta

Commands Commands Commands
Group 6.11* 4.67* 4.79*
Sex .62 3.45 .01
Group x Sex .02 .003 .07
Error (.0012) (.0003) (.0006)
Table 10
F-statistics for Compliance variables.

Non- Off

Compliance Compliance .EEEEEE
Group .46 6.03* 2.18
Sex 3.95* .000 .30
Group x Sex .06 .04 1.52
Error (.0003) (.0007) (.00005)
Table 11

F-statistics for
Seat.

Parent Positive

Statements, Inappropriate, and Out of

 

 

 

 

Parent Positive Out of

Statements Inappropriate ‘Sggg
Group 1.55 3.26 .28
Sex 1.28 1.66 2.22
Group x Sex 4.09* .11 1.28
Error (.OOOO7) (.0014) (.026)

 

Note. df - 1,58 for all F-statistics.

*p < .05.

Chapter 5

Discussion

 

The present study was designed to develop and validate 3
behavioral observation coding system for assessing mealtime family
interaction patterns and individual child behaviors of ADD-H and non-
ADD-H children and their families. Although many psychometrically
sound coding systems have been published (Patterson, 1977; Patterson et
31., 1978; Wahler et 31., 1976; Mash et 31., 1973; Forehand et 31.,
1978), none were specifically designed for use with ADD-H children and
their families during 3 mealtime setting. The mealtime setting was
chosen as it has been noted as a particularly difficult time for
hyperactive children and their parents (Barkley, 1981a;
Goodenough,193l). The results of this study indicated that some of the
proposed behavioral codes were reliably scored by trained observers and
that, in general, the more reliable codes tended to correlate with
behavior ratings made by parents and teachers, and to discriminate ADD-
H children and their families from non-ADD-H children and their
families.

Using a 702 minimum reliability standard for the effective percent
agreement coefficient (Patterson et 31., 1978), the Child and Other
Interaction, Family Interaction, and the Command and Compliance
Categories achieved adequate interobserver reliability. The Out of
Seat code, at 622, was only marginally short of criteria while the
Parent to Child Positive Statements code and the Inappropriate Child
Behavior codes were moderately and very significantly short of the

criterion level, respectively. One explanation for the low reliability

67

68
for these latter three codes is that they were coded relatively
infrequently, and infrequently scored codes often yield low
reliabilities (cf. Jacob, O'Leary, and Rosenblad, 1978; Mash et 31.,
1973).

The Cohen's Kappa analyses revealed that for the Child and Other,
and Family Interaction codes, only the Neutral codes achieved adequate
reliability. The Positive and Negative codes for both of these
categories occurred quite infrequently and suffered from low
interobserver agreement. As found with the effective percent agreement
analysis, the Out of Seat code fell moderately short of the 602
criterion level set for the Cohen's Kappa analyses (Gelfand and
Hartman, 1975). The Parent to Child Positive Statements and
Inappropriate behavior codes were also found to be significantly short
of adequate reliability by this method. Alpha Commands, Beta Commands,
Compliance and Nonecompliance each demonstrated adequate Cohen's Kappa
coefficients, while the infrequently scored Off-Camera code
demonstrated extremely low reliability.

Generally, the Cohen's Kappa reliability coefficients found for
the present study were lower than those found for other coding systems
of approximately equal complexity. Using the Stony Brook coding
system, Jacob et 31., (1978) found Cohen's Kappa reliability
coefficients of 002 and 432 for the Aggression and Solicitation codes,
respectively. However, the other 15 of the 17 codes cited by Jacob et
al. demonstrated adequate reliability. In the present study, only six
adequate (>.60) and one marginally adequate Cohen's Kappa reliabilities

were found for the 14 separate codes. Jacob et 31. indicated that the

69
002 reliability score for Aggression was due to its only being scored
once by one coder and missed by another coder. In the present study
each code was found to occur more than once. However, the above cited
infrequent codes may have been missed by coders due to their becoming
highly focused on the more commonly occurring codes.

It is also possible that the low reliability scores for the
infrequent behaviors may have been exacerbated by the reliability
procedures. It has been demonstrated that although reliability
generally increases when observers are being overtly checked, observers
tend to score behaviors more conservatively, and hence, the more
complex codes are scored less frequently (Jones, Reid, and Patterson,
1975; Kazdin, 1977). Due to the nearly constant overt reliability
checking employed during this study, observers may have become
conservative in their coding and therefore hesitant to score the lower
probability codes.

Correlations with caretaker report measures and analyses of
diagnostic group differences were carried out in order to assess the
construct validity of each of the codes. In addition, 2 X 2 ANOVAs
were performed (diagnostic group X sex) to determine the discriminant
validity of each of the codes. Seventeen of the 51 possible
hypothesized correlations with the caretaker report measures were found
to be significant. Seven of the 19 possible group differences were
also found to be significant.

Validity was best demonstrated for the Command/Compliance codes.
Each of the Command codes discriminated ADD-H from non-ADD-H children

and significantly correlated with at least two of the three caretaker

70
checklists. Correlational findings for the Command/Compliance codes
suggest that children with higher Conners scores are more likely to
receive both Alpha and Beta Commands and to not comply with them than
are children with lower Conners scores. Families with greater reported
discord, as assessed by the Family Relations subscale of the PIC-R,
were found to give more Total Commands, especially Beta Commands, which
were more likely to be responded to with nonecompliance.

The present command/compliance findings are in agreement with
those of prior observational studies in that the frequency of parental
commands and child non-compliance has consistently been found to be
greater in families of hyperactive children (Barkley, 1981a; Cunningham
and Barkley, 1979; Bell, 1968, 1977; Campbell, 1975) and families with
behavioral problem or conduct disordered children (Griest et a1., 1980;
Patterson and Reid, 1970; Patterson and Reid, 1973), compared to
families of normal control children.

Barkley (1981a) points out that along with commands, compliance,
and contingent praise from parents, negative interaction (between
parent and child) was found to demonstrate high associations with
scores on parent and teacher rating scales and to demonstrate good
generality across settings. Although the present study did not find a
significant correlation between this code and the caretaker checklists,
the Negative Child and Other Interaction code was the only Child and
Other code to discriminate between the ADD-B sample and the non-ADD-H
sample. The Inappropriate child behavior code tended towards
significance with the hyperactive group demonstrating low levels of

these behaviors while no occurrences were found for the non-hyperactive

71
group. Although both of these findings were hypothesized, the low
interobserver reliability found for both of these codes suggests that
these relationships be interpreted with caution.

The failure of the Positive Child and Other Interaction and
Negative Child and Other Interaction codes to correlate with any of the
checklists is likely due to the very low reliabilities found for the
Positive and Negative codes, and the low occurrences of these behaviors
(see Appendix A). However, significant negative correlations were
found for the Total, Positive, and Neutral Family Interaction codes
with two of the three caretaker checklists each. These findings
indicated that both the mother's and teacher's perceptions of
hyperactive child behaviors were associated with certain family
interactions which exclude the target child. More specifically, the
families of the ADD-H children interacted less frequently among
themselves and had less positive interactions than the families of the
non-ADD-H children. One possible explanation for this general
reduction in family interaction is that reactivity to the videotaping
may have resulted in an inhibition of negative family interactions.
For families who are not accustomed to a high frequency of positive or
neutral interactions, it may have been difficult for them to
immediately exhibit such behaviors, even if they felt impelled by such
perceived demand characteristics from the videotape setting.
Alternatively, it is also possible that the families of ADD-H children
were not reacting to the observation procedures and do typically
interact less than the families of noneADD-H children in an attempt to

minimize the possibility of engaging the hyperactive child. In a

72
laboratory observation study, (Cunningham and Barkley, 1979) it was
shown that when hyperactive children and their mothers were alone in a
free-play situation and a structured-task situation, the mothers of the
hyperactive children initiated fewer social interactions and proved
less responsive to those interactions initiated by the child than did
normal control mothers. However, compared to the control group
mothers, the mothers of hyperactive children spent significantly more
time issuing commands which were responded to with more non-compliance.
The results of the present study taken together with those by
Cunningham and Barkley (1979), suggest that parents of hyperactive
children may be negatively reinforced for minimizing interactions that
would engage the hyperactive child, as many of these parent-child
interactions seem to involve control/compliance struggles and are
therefore unpleasant, and preferably avoided.

The results from the present study demonstrated a significant
correlation between three of the Family Interaction codes with the
Mothers, and two significant correlations with Teachers, scores on the
Hyperactivity Index on the Conners measures. The teachers had no
knowledge about the family interaction patterns and still rated these
children higher on the Hyperactivity Index on the Conners. These
results support the contention that ADD-H is a cross-situational
syndrome and that the specific child behaviors rated on the two Conners
measures do not appear to be situation specific.

The lesser frequency of Total and Positive Family Interaction
found in the ADD-H sample compared to the non-Add-H sample also lends

some support to previous research (Hartsough and Lambert, 1982;

73
Paternite, Loney and Longhorn, 1976; Paternite and Loney, 1980)
implicating the home environment in the designation of a child as
hyperactive. An extensive study by Paternite, and Loney (1980), looked
at various home environment measures including 838, measures of the
mother-father relationship, parent-child relationship, parent
discipline practices and styles, parental social competence, and
structure and routine provided in the home. Factor analysis results of
their study indicated that most of the significant relationships were
with secondary symptoms (child aggression) used as criterion variables
and not when primary variables (inattention and impulsivity) were used
for criterion variables. Although the present study did not code
measures of inattention and impulsivity, the results do support the
contention that some home environment variables (i.e. Family
Interaction patterns) are associated with higher scores on the
Hyperactivity Index on the Conners measures.

Although discriminant validity between hyperactive and non-
hyperactive children for out of seat behavior has been demonstrated in
laboratory free-play, restricted-play, and restricted-academic settings
(Roberts et a1., 1984), the present study failed to find significant
group differences or significant correlations with caretaker checklists
for this code. This code was originally hypothesized to be a general
measure of gross motor movement and as such indicated that the two
groups are quite similar in this respect. However, it is suggested
that the Out of Seat code was too inclusive and was affected by other
factors which should have been excluded such as parental requests that

the child leave his seat to assist the parent or another family member.

74
These latter Out of Seat behaviors were both parent directed and
qualitatively different than many observed incidents of more
inappropriate behaviors which were also included in the same category,
such as when the target child left his seat without permission or
directly disobeyed a parental request to be seated. Further
specificity regarding inclusion and exclusion criteria are needed for
this code to be used as a useful measure of gross motor movement in a
mealtime setting.
Future Directions for Research

The results from the present study indicate that a mealtime
setting allows for the observation of interaction patterns that
discriminate ADD-H families from non-ADD-H families. The mealtime
setting allows for a minimum of observer imposed restrictions and
should offer a valid sample of family interaction in the home. Future
studies need to further examine family interaction patterns in clinic
referred and non-clinic referred populations in an effort to replicate
and expand upon the findings of the present study.

When using a home-based mealtime setting, various video, audio and
procedural shortcomings encountered in the present study should be
addressed, as they likely contribute significantly to the low
interobserver reliabilities for some of the codes. Use of a
professional quality camera, a high quality wide-angle lens, remote
microphones and additional lighting would likely improve the source
quality significantly and hence increase interobserver reliability.
Improved videotape quality should also allow for greater accuracy of

transcriptions made from the tapes thereby enhancing their utility as

75
an aid to the coders. In addition, although slightly intrusive, a few
measures should be taken to add a minimum degree of structure to the
mealtime setting. For example, when necessary, family members should
be relocated around the table in order to allow for the best possible
view of the target child and the parents. However, as McIntyre et a1.
(1983) have argued one would need to assess the effects of reactivity
when restricting the environment in this manner.

To further improve the audio clarity, loud appliances such as
microwave ovens and refrigerators should be temporarily turned off. A
prior decision must also be made regarding whether to permit
televisions or radios to remain on during the videotaping. During the
data collection for the present study, it was observed that a large
percentage of the ADD-H families kept televisions or radios on during
mealtime, while this was not observed in the non-ADD-H families. It
was originally planned, for the present study, to code for this
finding, but it was later discovered that an overzealous videotaper had
requested of some of the families that they turn off their televisions
or radios, hence losing some of this data. It is suggested that
families with ADD-H children may use these distractions to help
minimize unpleasant interactions with the target child. Nevertheless,
radio and television volume levels should at least be reduced to
minimize interference.

It is also suggested that future observation research should
include repeated observations to increase the total amount of
observation time. Jones et a1. (1975) reported that a minimum.of 60-

100 minutes of observation time was needed for their more frequently

76
occurring codes to provide an accurate score. Multiple recordings have
also been used for the assessment of systematic reactivity or
habituation to the observation procedure. However, the assessment of
these potential confounds is not being encouraged as previous studies
seem to indicate that it is unlikely that they would be demonstrated.
In a summary of studies measuring reactivity and habituation (changes
in prosocial or antisocial behaviors) to the observation procedure,
Patterson (1982) concluded that both normal and withdrawn children can
be helped to "look good" during observation when adults intentionally
tried to manipulate them in that direction but that antisocial children
were less manipulable. The author also discussed the general lack of
evidence demonstrating reactivity in conduct disordered populations and
habituation to observation in a classroom setting with normal children
or other observation settings with conduct disordered children. In a
review article by Haynes and Horn (1982), the authors also conclude
that reactivity to direct observation tends to be non-systematic.
However, repeated measures totalling a minimum of 60-100 minutes should
be employed in future studies as a means of increasing the stability of
the codes .

Future research should also focus on measuring antecedent and
consequent events similar to those used by the Patterson et a1.,
Forehand et a1., and Nash et a1. groups. Further refinement of the
present code, and adaptation of other codes capable of measuring
antecedent and consequent events for use in minimally structured home
settings, will likely yield highly valid and generalizable information

about the directionality of interaction patterns between family

77
members. Although some studies of ADD-H populations have found
evidence for the reciprocal nature of parent-child interactions using
laboratory observations (Barkley and Cunningham, 1980; Cunningham and
Barkley, 1979) and classroom reports (Meichenbaum, 1977), home based
observational research on the bi-directionality of interactions between
ADD-H children and their family members is practically nonrexistent.
Modification of the present coding system and procedures to increase
interobserver reliability for some of the codes, and allowing for the
observation of antecedent and consequent events, appear to be logical
next steps toward the development of a data base for this neglected

area of research.

APPENDICES

APPENDIX A

TABLES

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81

Table 13
Means and standard deviations for all behavioral codes and caretaker
checklists of child behavior.

 

 

”natives Controls
blea Pea-16a Ilalea Paaalaa

Matias Genera
has 21.65 21.00 2.35 2.69
00 6.71 6.05 2.10 1.76
teacher Ca-ata
baa 10.12 19.57 5.53 5.11
50 6.10 5.71 5.12 1.69
PIC-l P-tly lalatiaaa Scale
lbea 57.00 51.00 52.50 55.00
50 9.32 0.57 11.12 9.50
fetal 000 lat
baa .561 .606 .527 .507
SD .165 .161 .195 .126
Positive C00 lat
Maea .020 .059 .067 .036
50 .065 .069 .035 .031
lautral 000 1st
Item .697 .609 .676 .665
$0 .167 .110 .100 .137
lautive C60 lat
be. .016 .036 .006 .006
50 .052 .057 .010 .010
26:61 0‘17 lat
ha .55 .532 .670 .796
00 .250 .255 .205 .156
Paetttve 9‘” lat
baa .026 .019 .066 .006
50 .060 .022 .075 .116
lemtrel nun 1st
Ihaa .506 .501 .601 .700
50 .265 .261 .267 .160
legative 7.617 1st
baa .005 .012 .005 .002
00 .013 .013 .000 .005
inappropriate
lean .010 .026 O O
50 .0620 .0555 0 0
Out a! Seat
lines .129 .155 .062 .202
$0 .167 .116 .060 .220
Pataat Poattive
Statanata
Mean .00) .005 .010 .001
50 .006 .006 .010 .003
Total (i.e“
naea .060 .052 .056 .026
00 .061 .056 .022 .017
Alpha Can-ale
baa .020 .019 .017 .000
00 .019 .017 .016 .ms
late 0.“
llama .051 .036 .017 .01.
$0 .027 .029 .012 .015
Ceapltaeca
Iaaa .021 .012 .010 .000
50 .010 .007 .017 .009
lea-c.11aaca
has .036 .032 .013 .015
50 .032 .025 .012 .000
Off-c-ara
'5“ ~005 .006 .oo: .oo:
00 .000 .016 .005 .005

 

Note. Means and standard deviations for all behavioral codes are based
on the frequency of occurrences divided by the number of intervals for
each family (approx. 120). Means and standard deviations for the
Mother Conners, Teacher Conners and PIC-R Family Relations Scale are
based on actual scores.

APPENDIX B

THE OBSERVATION CODE

82
APPENDIX B

11 I i . l :2 3'

The hyperactivity coding system is designed to describe
patterns of family interactions during a 20 minute. home
based. meal-time setting. It is a behavioral coding system-
and as such. observations of overt behaviors are measured.
It is the aim of this system to quantify the occurrences and
describe the sequences of select behaviors. The primary
purpose of the code is as a research instrument to
discriminate hyperactive children from non-clinic referred
children. and to assess the efficacy of a treatment design.
The code should also offer practical utility as an
assessment tool for clinicians. Its capacity to describe
select behaviors should prove to be beneficial for designing
individual intervention programs.

The code is inclusive and complex enough as to require
the use of videotape recording and could not be used
effectively with live observers. Once a videotape recording
of the family has been made. it must be divided into
continuous ten second intervals. This may be done with the
addition of a voice track. counting the intervals placed on
one of the audio tracks of the videotape. Interval timing
may also be designated with a visual counter superimposed on
the videotape so that it would appear on the monitor screen.

Once the tape has been prepared. by the addition of a
visible or audible interval track. it must be transcribed
verbatim and then coded in two separate viewings. This is
done to allow the coder to focus on only a limited quantity
of behaviors during any single viewing. Each passage
through the tape is coded on a corresponding coding sheet.
The scoring sheets are specifically designed to enable
precise scoring of the specific behaviors to be viewed
during each viewing.

The first viewing (Interaction/Inappropriate/Positive)
is. in part. to provide a rating of the quality of the
interaction for the 10 second interval. This is done
separately for the interaction between the Child and Others-
and the Family. The family interaction includes any
interaction in which the target child is not included.

Child and Other interaction and Family interaction are
scored in terms of global ratings (Positive. Neutral or
Negative) which designate the general quality of the
interactions during the 10 second interval. On this
passage. the coder is also looking for the presence of any
‘Inappropriate child behaviors. and Out-of-Seat behaviors by
the child and any Positive Statements from the parents
toward the child. Each interval is scored for the presence
or absence of these selected behaviors. An interval

83

recording measure is used for these codes such that a single
rating of the quality of interaction is scored for the 10
second interval for the two interaction codes and a check-
mark is recorded to denote the presence of any of the above
behaviors for the interval.

During the second passage through the tape (Other to
Child). the trained coder is to focus only on command
behaviors issued by parents and directed toward the target
child. An event recording measure is used such that each of
the commands and the child responses are coded. The
selected behaviors are fully described under the Command and
Compliance subheadings. Parental Command behaviors require
that one of the Compliance codes be used to score the
child's behavior. These codes are scored on the coding
sheet labeled Other to Child.

ZIIUSSCETQIJCZUPJICDBISS

1. Sign out a stopwatch from the psychology office in the
Psychology Research Building.

2. Sign out the key to room 119 from the same office.

3. Unlock the door. leaving it slightly ajar. and return the
key immediately.

4. Check the list to see which families you are responsible
for coding and do only those families to which you are
assigned.

5. Select the appropriate coding sheet for your viewing of
the videotape and fill out the top of the sheet. Make sure
that the family name. family number. and the date of taping
are included on every coding sheet that you use. along with
your name and today's date.

6. Select the appropriate transcription folder containing
all of the family's verbalizations for that tape. or the
shorter transcription containing just the commands. This
will help you understand what you are hearing.

7. Turn on the videotape player. place the tape in. and
locate the family that you need on the tape. You may have
to go to the beginning of the tape and fast forward it
family by family until you find the one that you need.
Remember that each taping is about 20 minutes and thus the
amount of tape used for each family is approximately the
same. Watch the tape counter on the machine.

8. When you are ready to start coding. place the headphones
on. start the tape. and try to concentrate on only the
behaviors that you are looking for. Use the transcription
sheets as an aid but remember to listen and watch carefully.

84

9. Remember. this is for science! It may also affect your
grade. Do your best. Good luck.

(SEBIJIEIQIKI. C2C>ll£31tt3£££2l¥fi?12(31153
FPCDFI CZCDIDJZEICS

I' .
For many of the codes. time is an important factor in
determining which behavior has actually occurred. It is
crucial that a stopwatch be used to accurately determine the
duration between certain behaviors. When timing is needed.
as described in the code. it is always measured between the
offset of the first behavior and the onset of the second.
For example: When a Command is issued. the target child has
five seconds from the end of the command in which to
respond. or a code of Non-compliance is given as the
response. This five second period is measured from the end
of the last word in the command to the beginning of the
response.

Do not code verbalizations that are not within camera view.
unless you are sure of what was said and by whom. If there
is anx,§gnh1. such as a situation when two people are off-
camera at the same time and you are forced to decide who
spoke. d9,n21‘gggg. Verbalizations should be coded if there
is only one possible person speaking who is not in sight.

(DUPIiIEIQ CD13 (311131.!)

I . W (COWDS)

CODE ONLY COMMANDS BY PARENTS. DO NOT SCORE PAREflTAL
SOLICITATIONS.

W:

Commands must be directive in content. i.e. direct a
child's behavior. Look for action verbs to identify a
command as opposed to a request for information.

”How was your day?" (not a command)
”2311 me about your day." (example of a command)

Commands must be directed only to the target child as
opposed to more than one child or the rest of the
family. This is to avoid confusion about whether the
target is considered as part of the group for whom the
command is intended.

A.

85

”Everyone finish your dinner." (not a command)

A command must not tell a child to do what he wants.
i.e. it must direct the child in a manner which
conveys the wish of the parent.

“Take what you want." (not a command)

"If you want it. you ask properly.” (This is not a
command as the child is given a choice and does not
have to respond.)

“Come on.” (not a command)

The word ”just.“ (Ignore this word when it is used
in a sentence containing a command. Code the
command as if the word ”just" were not included.)

If a command requires a motoric response. but the
response is not visible due to the camera angle. then
code the command and score Off-Camera (00) for the
Compliance code. (See Child Behaviors.)

ALPKA COMMANDS (AC)

These are commands. rules. questions. or suggestions
to which only one specific verbal or motoric response
is appropriate and feasible.

LEW:

Must have a clearly specified objective.

Must be explicitly stated. leaving no doubt as to
what the child is supposed to do. such as
instructions to the child to start doing a specific
thing.

“Eat your meat.”

"I want you to ...”

”I would like you to ...”

“You need to ..."

“You better ...”

”Finish eating.” (The child must start eating
within five seconds to comply.)

”Sit closer to the table” or "Lean closer to the
table" (The child must move noticeably closer to
the table.)

“Put your chair down.” (The child must put the
chair down so that all four legs are on the
floor. or so that the child appears to be sitting
on a level surface if you cannot see the chair
well enough.)

86

”Say when.” (The child must indicate that he has
received enough of the item to comply.)

“Shut up" (The child must not speak for

five seconds to comply.)

”Be quiet.” (The child must not speak for five
seconds to comply.)

”Speak up.” (The child must repeat or rephrase
statement to comply.) '

"Please.” or ”Thank you.” (When stated in a
command form indicating that the child should say
please or thank you. the child must say ”please”
or ”thank you” to comply.)

”Turn around.” (The child must turn so that he is
facing in a forward direction. i.e. facing the
table.)

2- W:
Must have a gtgtgg_;gfig;gn1 to distinguish them

from vague commands.

Must instruct the child to cease an ongoing
behavior or not to begin a behavior that is about
to take place.

Must allow the child five seconds to initiate
inhibition of behavior and the child must maintain
inhibition for at least five seconds to be scored
as compliance.

3- W:

Must be prefaced by a question and involve a
motoric response.

Must be scored as question commands. even if they
are also stop commands.

W:
”Why don't you stop kicking the table?"
”Can you tell me...?'
”Shouldn't you use your fork instead of your
hands?”
”Hand me the salad. will you?”

mung:
“What did I just tell you?” (This is no; a
command and is considered a request for
information.)

4. W:

Include Permission and Rule statements which
contain contingencies and ”If...then" statements.

 

 

87

Are contingency statements that may be

warnings. or refer to positive. neutral or
negative consequences. or negative events not
administered by either parent. such as

natural consequences. The statement must imply
direction. letting the child know what the parent
wants him to do.

SCORE ACCORDING TO THE RESPONSE MADE TO THE DESIRED
COMMAND AND NOT TO THE CONSEQUENCE

Examples:
"If you don't stop playing with your food. I'm
going to take it away.”
”If you don't stop playing with your knife. you
will get hurt.”
”I'll be so proud of you if you finish all your
dinner." (also code on the Interaction sheet as a
positive statement)
“I'll be so proud of you if you stop talking now
and start eating. (also code on Interaction
sheet as a positive statement)
"You can either finish your dinner or not have
dessert with the rest of us.”
“You may sit down right now or go to your room.”

Statements in which the child is given a choice
between two or more options. but no negative
consequence is stated and no change in behavior
is requested. These are general statements which
offer the child a choice and neither option is
implied or stated to be preferable. i.e. ”You may
have milk or water." (This is not a command
Unless the child asks for something different
which the parents do not want him to have. In
such a case. milk or water would clearly be the
parents' preference. and would be considered a
General Contingency statement. In this case the
child is commanded to take either milk or water.
If the child takes either of these choices. code
the action as compliance. If the child insists
and takes either nothing or the choice that the
parent finds unacceptable. code this as non-
compliance.

5- W:

Include statements or rules that specify a
behavior to be initiated or inhibited in the
present with no contingency stated.

“There will be no more eating with your hands."
“You could use a fork.”

”You should not talk with your mouth full.”
“You may take more bread.“

“It would be nice if you ...“ (as opposed to ”I
want you to...')

BETA COMMANDS (BC)

These are generally poor commands to which the child
has little or no opportunity to comply.

1- 2W:

Include commands to which compliance is difficult
if not impossible.

Lack an operational referent in behavior.

Are the opposite of Labeled commands.

Includes commands to which more than one response
is possible.

ALL VAGUE COMMANDS ARE SCORED AS NON-
COHPLIANCE (WC)
M:

“Be nice to your sister.”
“Just be good for a while longer.”
“Calm down.”
"Do it right.”
“Try your best.“
“Think hard.”
”Be careful.”
”Good enough.”
“Wait.“
“Wait a second (or a minute).” (This is
considered Vague because one can't be sure what
the parent means by ”wait" or know how to
measure compliance.)
'Shhh.”
“Sit still."
“Sit up."
“Lean up.”
“Don't do that.”
'Use your napkin.” or ”Use your fork.” (Any
statement commanding the child to “use” something
is considered vague unless the statement is
further qualified. i.e.. telling the child what
to use it for.)

“Use your napkin to wipe your face.” (This is a
Labeled command because it tells the child what
to do with the napkin.)

89

If a pronoun is used in a command. consider the
command as Vague. unless you are 95% certain that
you know what the pronoun is referring to. based
on the context of the situation. If you are
confident that you know what the pronoun is
referring to. score the command as an Alpha
Command.

Examnls§=
“Don't use that." (The child puts his fork in the
glass to stir.)
“Don't do that.“ (The child throws her napkin on
the floor.)
'Put it down.” (The child picks up his steak with
his hands.)
“Eat that.” (The parent points to a specific food
object.)

2. SHA1E_QQHHAND§

A series of logically or practically related
commands that are given within 5 seconds.

Each command must be a complete command by itself.
Score compliance only if all commands in the series
are complied with.

If a command is issued and then complied with by
the child. and then another command is issued
within five seconds. score these as two separate
commands even though they occurred within five
seconds.

SCORE AS COMPLIANCE or NONCOMPLIANCE (C. or NC).
TIME COMPLIANCE STARTING FROM THE END OF THE
LAST COMMAND ISSUED.

“Sit down and start eating."

”Face forward and leave your sister alone."
“Instead of talking to your sister. start
eating.” (This is no; a chain command. but is
scored as a single command referring to the
eating command.)

3. BEEEAIED_QQHMAND§ (RC)

.The parent issues the same command or similar
versions of a command within five seconds.

Code as a Repeated Command whether the command is
repeated once or more.

Include commands in which the child does not hear
the command the first time and says “what“ or “huh”
in between the parental commands. Hence. any time

90

a command is repeated within five seconds
regardless of the child's verbal responses. unless
the verbal response is an act of compliance

itself. the command is scored as a repeated
command. In this case the second command is

scored as a separate command of whatever type

it would be. as it stands alone and the child would
receive a Compliance score for the first command.

IF ONE OR MORE OF THE COMMANDS WITHIN A REPEATED
COMMAND IS/ARE VAGUE. BUT AT LEAST ONE ALPHA
COMMAND IS ALSO WITHIN THE COMMAND. THEN SCORE THE
COMPLIANCE TO THE COMMAND AS IF THE COMMAND WAS AN
ALPHA COMMAND AND NOT A VAGUE COMMAND. A REPEATED
COMMAND IS SCORED AS A VAGUE COMMAND ONLY IF ALL OF
THE COMMANDS WITHIN IT ARE VAGUE.

SCORE THE RESPONSE ACCORDING TO THE LAST TIME THE
COMMAND WAS ISSUED.

28913519:

Commands referring to 2351 or future behavior are
not scored as commands. To be considered past or
future a referent must be stated or content must be
such that the behavior is not meant to take place
in the dinner setting. To be considered a future
command. the desired behavior must be such that it
cannot realistically be started within five
seconds or is clearly not meant to be started
within five seconds. However. if a child is
instructed to cease a behavior that he has just
stopped doing within the last five seconds - code
the command and whether or not the child complies
by continuing to not exhibit the behavior for five
seconds after the command is issued.

”Take out the garbage after dinner”.

”If you had done what I told you earlier. you

wouldn't have this problem.”

"If you had done your work last night you would

be free to play tonight.”

“Be nice to your sister when we are gone.”

"Eat all of your dinner." (THIS CAN BE SCORED AS
A COMMAND EVEN THOUGH IT MAY BE UNLIKELY THAT THE
CHILD WILL FINISH WITHIN FIVE SECONDS. IF CHILD
INITIATES THE APPROPRIATE RESPONSE THEN CODE AS

We)

91

II. QBLLD_BEHAXLQB (child responses to parental commands)

A.

COMPLIANCE (C)

The child obeys or complies with a parental command
or with a series of commands within a Chain
Command. within five seconds of the completion of
the command.

Appropriate verbalization within 5 seconds after
a command requiring a verbal response.

Movement toward a specified goal object within 5
seconds.

Initiation of a specified task within 5 seconds.
Inhibition of a specified motor or verbal
response for 5 seconds.

Initiation of the inhibited response must also
occur within 5 seconds of the termination of the
parental command to qualify as Compliance.

If the child meets the above criteria for all of
the commands in a chain command. then score as
Compliance.

For chain commands. start timing after the last
command is issued to score as Compliance.

as Compliance:
If a child is commanded but has complied before
the parent finishes stating the command. score
compliance at the instant that the command was
completed.
If a child is commanded but the parent has just
completed the task that the child was commanded
to do. score compliance at the instant that the
command was completed.

NON-CWPLIANCE (NC)

The child refuses to comply or does not respond to
parental command within five seconds. Score in

the interval in which the fifth second occurs.

If the child failure to initiate compliance within
5 seconds of the termination of the parental
command. score as Non-compliance.

Also score as Non-compliance the child's failure to
maintain inhibition of a prohibited response for 5
seconds.

92

The Child is allowed five seconds to initiate
inhibition of behavior and must maintain
inhibition for at least five seconds.

The target child is allowed five seconds to
initiate the behavior that he is commanded to do.

This five second period is measured from the end
of the last word in the command. A command has
ended as soon as the actual directive statement

has ended and not necessarily at the end of the
sentence.

”Eat your meat because I spent all day preparing
this meal and don't want it going to waste;"
start timing after the word ”meat".

 

C. OFF-CAMERA (0C)

If a behavioral response is assumed to have taken
place but cannot be seen due to the person being
out of camera range. code as Off-Camera.

JZIUUPEEFZIKCBUPJI(DIG/’Ttlilklal’FZCDI’F?JEIKUPEEI’
1°CDESIECDT[\IIE SSUPIKUPEELJEELT1?E§

III. 1mm (POSITIVE. NEUTRAL. NEGATIVE)

The general affect and quality of the interval.
If the interval contains any solicitation. command
or verbal interaction - code as interaction.

A response to a solicitation or command is not
needed to code an interaction.

If a family member makes a vague or general
solicitation and only the child responds - code
under Child and Other Interaction.

If a family member makes a vague or general
solicitation and no response is given. or someone
other than the child responds - code under Family
Interaction. The interaction must be verbal or
clear behavior acknowledging another.

Included in the definition of interaction are
responses such as laughing or ”um hum"

or clearly shaking head as an acknowledgment.

A.

93

When judging the quality of the interaction. all
members involved in the interaction must be
considered. If one negative interaction occurs.
score the interval as negative. even if another
positive event occurred during the interval.
However. if a parent makes a positive statement
to the target child during the interval. be sure
to mark its occurrence under the Positive
Statements column. If any positive behavior
occurs during the interval. score the interval as
positive for the members involved i.e.. Family.
Child and Other. or both. unless a negative
interaction also occurs. The passing of food. or
related items. is scored as a neutral interaction
if verbal interaction is included and
conversation is extended beyond the request. or
offer. and response. No interaction is

scored if no verbal behavior is included or
verbal interaction is limited to the passing
itself. A "thank you.” or similar praise is
recorded under the Positive Statements code. but
may not be a sufficient criterian for scoring the
interval itself as Positive.

Members must interact with family members other
than the target child. If family members interact
only with the target child. code as Qh11g_gnd
Other.

Do not score the gestures or verbalizations of an
infant or young child (defined as any child
seated in a high-chair or a booster seat) unless
a response is made by another family member. If
a response or a solicitation is made by the
target child to the infant. code as Child and
Other interaction using the target child's
behavior as the determinant for the quality of
the interaction. If any other family member
responds or solicits the infant. code as Family
interaction and use the behavior of this

person or persons to determine the quality of the
interaction. Code separately for Child and Other
and Family. ‘

POSITIVE INTERACTION (+):

Includes any interaction which is clearly positive.
that is an interaction in which a reasonably good
tone of voice is used by both or all members
involved.

C.

94

Also includes laughing: defined as a person
laughing aloud. pleasantly and in an agreeable
manner.

NEUTRAL INTERACTION (O):

Encompasses normal table conversation with minimal
positive or negative affect. in which the tone of

voice used and the content of the conversation are
also considered.

NEGATIVE INTERACTION (-):

Includes any interaction which is clearly
negative such as: scolding. anger. exasperation
or a negative tone.

Also includes any family member making fun of.
humiliating. shaming or embarrassing another
person. The tone of voice (nastiness or
derisiveness) as well as the language used. are
of prime importance in meeting the criteria for
scoring an interaction.

OCCURRENCE OF ANY OF THE BEHAVIORS DEFINED UNDER

D.

THE CATEGORY OF INAPPROPRIATE CHILD BEHAVIOR.

”You stupid kid!” (said in a derogatory fashion).
"How did you get a 90 on your test? You

must have cheated!“

”Can't you do anything right?"

Laughing used as a form of put down.

”I don't care!” or ”I don't care what you did.”
(said in angry tone)

“Stop picking at your food." (said in angry tone)

INAPPROPRIATE CHILD BEHAVIOR

The occurrence of any of the following
inappropriate behaviors. Place a check in the
designated column labeled Lngnngpgigtg to denote
the occurrence of this type of behavior.

l-W

Crying and yelling are self-explanatory.

Child whines over minor injuries or not
getting what the child wants or requests.
Child nags parent in order to get something or
get something done.

Child seeks attention by whining.

 

95
2-W

This includes behaviors in which the child
damages or destroys an object or attempts or
threatens to damage an object or injure a
person. The potential for damage to objects or
injury to persons is the critical factor. not
the actual occurrence.

biting. kicking. slapping. hitting. or
grabbing an object roughly away from another
person. or threatening to do any of the
preceding.

3.2mm

This encompasses all inappropriate child verbal
behavior. including stated refusals to comply
(not the act of non-compliance). even if
compliance would be expected to occur at a later
time. Thus. any time the child states that he
will not comply with a parental command. score
as inappropriate behavior.

Deviant talk also includes disrespectful (sassy)
statements or gestures. profanity. and commands
to parents that threaten aversive consequences.

4-W

When the child makes fun of. shames or
embarrasses another person. The tone of voice
(nastiness or derisiveness) as well

as the language used. is of prime importance in
meeting criteria. Derisive or inappropriate
laughter can also be humiliating.

”You dumb old grouch!” (said in a derogatory
fashion)

To a sib. ”How did you get a 90 on

your test? You must have cheated!”

”Can't you do anything right?"

Laughing as a form of put down.

ALL OF THE ABOVE INAPPROPRIATE CHILD BEHAVIORS ARE
SCORED THE SAME

OUT OF SEAT :

Includes any time the child stands or leaves his
seat.
Also includes any time both buttocks are off the
seat.

 

96

Code Out of Seat regardless of whether parental
permission has been granted. and code only once
in a 10 second interval.

POSITIVE STATEMENTS

Any statement referring to the child or the child's
.ngigg. gagging. or fulfil; behavior that is positive
in evaluation or shows approval. Any time a parent
offers to do something for the child which may be
seen as pleasing or positive. even if it is a
future reference.

All time references are included.

A POSITIVE STATEMENT IS CODED WHETHER IT OCCURS AS
A RESPONSE. SOLICITATION. OR DURING AN

INTERACTION. THIS IS DONE UNDER THE CATEGORY OF
”PARENT TO CHILD POSITIVE STATEMENTS." THUS. ANY
TIME A PARENT OFFERS PRAISE. REWARD. OR GRATITUDE
TO THE TARGET CHILD - IT IS CODED BY CHECKING THAT
A POSITIVE COMMENT HAS GIVEN TO THE TARGET CHILD IN
THAT INTERVAL. THIS IS AN INTERVAL MEASURE AND IS
ONLY CODED ONCE PER INTERVAL REGARDLESS OF HOW MANY
TIMES IT HAS OCCURRED IN THAT INTERVAL.

(Parent) "Would you pass me the salad?"
(Child) Passes the salad

(Parent) ”Thank you" (praising child for his
behavior)

(Parent during ongoing interaction) "It is
nice to see that you are doing better in math
now.” (praising child for his accomplishment)

SCORE ALL THREE OF THE FOLLOWING CATEGORIES AS
POSITIVE STATEMENTS:

1-W
W

“You did a nice job on that task.”
'I like it when you do as you are told."
”Your teacher said that you are doing well."

LEW
W

Examples:
”Thank you"

”You're welcome"
"Good”
”You are such a good kid.”

97

"Wow!"
”Right” (stated as positive or reinforcing)

3~W
W

W:
”You did that very well.”
”Billy is doing well.”
”You are doing a fine job.”

APPENDIX C

VIDEOTAPE PROCEDURES

APPENDIX C

I | l' E Q |° N'I | E . |

1.

Remove tripod from case and set up. Make absolutely sure
that all the legs are tightly secured so that it will not
collapse on you.

2.

Gently remove the camera from the case and secure it to the
top deck of the tripod. using the screw that is tightened by
the knob underneath that deck.

3.

Remove the record/playback unit from the case. The
batteries should be kept charged by the last user of the
equipment and can be found in the pocket inside the case or
inserted in the side of the unit. If there is any doubt as
to the amount of charge on the batteries. use the power-pack
for the recording. Insert either a charged battery into the
side of the unit or the output cord from the power-pack into
the back. under the fold-down flap. If the power pack is
used make sure it is plugged in and that the on switch is
pushed in.

4.

Plug the thick black cable from the camera into the side of
the record/playback unit. It will only go in one way. so
make sure that the marks on the cable and unit are lined up

properly.

5.
Turn the power on by the switch on the upper left side of
the record/playback unit.

6.

Press the eject switch just below the power switch. insert a
tape and gently close the deck. The unit will automatically
wind the tape a little so don't let it worry you.

7.

. Just press the record and play
buttons on the unit at the same time and it will
automatically put the pause on also.

98

 

99

8.

Take the cap off the lens and set the focus on the lens.
This is done by zooming in on an object. as close as the
lens will allow. and turning the outer front ring around the
lens until the object appears as sharp as possible. Select
an object near the center of the table to focus on so that
you achieve an average focus for the whole family. Then
zoom back to widen the shot until the entire family is
included.

9.

When the family is seated and ready to begin eating.
acknowledge that you are ready to begin. Tell the family
that you would like to tape them for 20 minutes or until
they are done eating and that you would like them to try to
behave as they normally would. Do your best to be as
unobtrusive as possible.

10.

Start taping and look at the time on your watch so that you
know when 20 minutes is up. There is a counter on the
recorder which will give you the exact time of the
recording. If the family is almost done eating at 20
minutes or finishes a little early. you may record them as
they sit and talk or start to clean up. It never hurts to
get extra data!

11.

After 20 minutes. press the stop button on the recorder and
inform the family that you are done taping. Thank them for
their cooperation and begin dissassembling the equipment.

12.
Place the equipment back in its appropriate place in the
case.

)3.
Put the tape back in its case making sure you have first put
the name of the family and the date of testing on the tape.

14.
Thank the family again before you leave.

15.
Say good-bye and leave!

100

II H'I l' E . |

1.
Remove camera from case.

2.
Remove tripod adapter. lengthen. and lock the silver lever
on the side.

3.
Line the tripod adapter up on the bottom of the camera. with
the contact points properly together. and tighten.

4.
Screw the camera on to the tripod by tightening the lower
knob first and then the upper one.

5.
Remove the handle and attach to the front of the tripod
adapter.

6.
Remove viewer and screw on to the top of the camera.

7.

Line up the cable from the viewer with the ”VP" input on the
back of the camera. This is done by making sure that the
cable is facing up and then carefully inserting the delicate
contacts into the ”VF” input.

8.

Remove the microphone and attach to the right side of the
camera. This is done by lining up the plastic guide and
screwing the microphone on to the camera.

9.
Plug the microphone cable into the ”mic" input on the back
of the camera.

10.

Make sure that all the switches are set properly on the
camera. The ”white balance” should be all the way to the
right. The ”display“ switch should be on off.

The 'pwr” switch should be on normal.

ll.
Follow the rest of the procedure on page one.

 

101

W

When they come to the door. introduce yourselves. and say
that you're there to do the videotaping as previously
arranged. Tell them that you need a few minutes to set up
the equipment and ask where you might do that so as to get
the best possible view of everyone. Remind them that the
actual taping will take 20 minutes and that they should
simply act as if you were not there. as much as possible.

If they try to engage you in conversation during the taping
politely say. "Please just try to act as if we were not
here." If they try to talk about problems the family or
children are having. politely tell them that Dr. Horn does
not want the videotape people to hear anything about such
problems but that they may call Dr. Horn if they so desire.
The family will already have been told that you are only
there to videotape. Under no circumstances accept an offer
of anything to eat. Politely thank them and say that you
ate before you came (it might be a good idea if you actually
did this). When the 20 minutes are up quietly dismantle the
equipment. thank them for allowing you to come. and leave.
Do not stand around talking to the family when you are done.
Remember at all times that you are representatives of the
HSU Psychological Clinic and the Child Behavior Project.
Dress neatly (no jeans or sweatshirts). Do not swear or
spit on the carpet. and all will go well.

 

102

SOUND ON SOUND

 

The purpose of this procedure is to create a new videotape
containing the original audio and video tracks from the family
observation tape, in conjuction with the audio interval track from
the cassette deck. This can only be done with the use of the Beta
Hifi Toshiba unit. The Sony unit will serve as the playback unit
while the Toshiba will record. The video and audio portions of the
playback tape will be separated. The video portion of the family
tape will be plugged into the video input on the Toshiba. The audio
portion will be plugged into either the left or the right audio
input. The output from the cassette deck will be plugged into the
other audio input on the Toshiba. The Toshiba will be set-up to
blend the two sound tracks so that both audio signals will be placed
on both audio tracks of the new tape.

INSTRUCTIONS

 

Use only the left output of the cassette deck to run into the
Toshiba audio input.

Turn on the tape deck, Toshiba, T.V., and the Sony Beta unit,
including the power supply.

Make sure that the "VCR" light is lit on the Toshiba.
Make sure the Toshiba is switched to Beta III.

Put the original tape in the Sony unit.

Put the blank tape into the Toshiba.

Reset the counters on the cassette deck and the Sony.

Push ”Record" then wait about one second and push the ”Pause" button
on the Toshiba.

Push the "Pause” then the "Play" buttons on the Sony.

Determine where the voice track on the cassette tape actually
starts. Set it so that you know when the voice will start in order
to match it properly with the beginning of the video tape.

Push the ”Play" button on the cassette deck.

Release the pause buttons on both the Toshiba and the Sony at the
same time.

Each family on the tape will last about 20 minutes. Make sure that
you are watching to see when the family taping is finished.

Stop the Toshiba first by using the ”Pause" button.

APPENDIX D

CODING SHEETS

MWMWDID

CODING SHEET
l
INTERACTI CIN/INAPPROPRIATE/POSITIVE

 

 

 

 

TAPE H FAMILY fl DATE OF TAPING
CODER - NAME DATE TIME
INTERACTION INAPPROPRIATE POSITIVE STATEMENTS

INTERVAL CHILD & OTHER FAMILY INAPPROPRIATE OUT OF SEAT SELF-STIM O to C POS STATEMENTS

 

 

m3

TAPE A FAMILY

CODER - NAME
COMMAND

mm

 

104

CZCDIDIIIJCS SSIIIEEEUP

2.
OTHER TO CHILD
A DATE OF TAPING

 

DATE TIME

 

 

W

 

 

APPENDIX E

INSTRUMENTS

 

PLEASE NOTE:

Copyrighted materials in this document
have not been filmed at the request of
the author. They are available for
consultation, however, in the author's
university library.

These consist of pages:

105-114

 

 

 

 

 

 

Uni '
[Vleigoltyfilms
International

300 N. ZEEB RD. ANN ARBOR, Ml 48106 (3l3) 761-4700

APPENDIX E

II
PERSONALITY INVENTORY

FOR CHILDREN

REVISED FORMAT
ADMINISTRATION BOOKLET

 

byHOUtHT U. WIHT. PhD.
PHILIP D. SEAT, PhD.
WILLIAM E. BROEN. Jr., PhD.
Revusion by DAVID LACHAR, PhD:

Publaslwd by

t "’ VISIIIN PSICNCIOCICAL “NVICIS
human and Gunmen"
non nun-o lbw-um
Lu motes COMO-mo WIS

 

 

This inventory con5ists of Statements about children and family
relationships.

DIRECTIONS: FIRST FILL IN THE INFORMATION REQUESTED ON THE ANSWER
SHEET. TO ASSIST YOU IN FILLING IN THIS INFORMATION LOOK AT THE
THE EXAMPLE OF A COMPLETED ANSHER SHEET ON THE FOLLOWING PAGE.

AFTER FILLING IN THE INFORMATION REQUESTED ON THE ANSHER SHEET,
READ EACH OF THE STATEMENTS IN THIS BOOKLET AND DECIDE HHETHER
IT IS TRUE OR FALSE AS APPLIED TO THE CHILD.

 

Suthun olanswur
LOOK AT THE EXAMPLE OF THE ANSWER SHEET SHOHN SHWHLUHUUW
AT THE RIGHT. IN THE EXAMPLE THE PARENT mamco
DECIDED THAT STATEMENT 25 HAS TRUE AS APPLIED
TO THE CHILD AND STATDHENT 26 HAS FALSE AS
APPLIED TO THE CHILD.

I Ir
25 'p (j
26G a

 

 

 

IF A STATEMENT IS TRUE OR MOSTLY TRUE. AS APPLIED TO YOUR CHILD,

USE A PENCIL TO BLACKEN THE CIRCLE LABELED I (SEE 25 IN THE
EXAMPLE). IF A STATEMENT IS FALSE OR NOT USUALLY TRUE, AS APPLIED
TO YOUR CHILD, BLACKEN THE CIRCLE LABELED 5 (SEC 26 IN THE EXAMPLE).

IN MARKING YOUR ANSWERS ON THE ANSHER SHEET, BE SURE THAT THE
NUHBER OF THE STATEHENT AGREES RITE THE NURSER ON THE A5535?
SHEET. MAKE YOUR MARKS HEAVY AND BLACK. CHASE COMPLETELY ANY
ANSWER YOU HISH TO CHANGE. DO NOT MAKE ANY MARKS ON THIS BOOKLET.

105

106

 

 

 

 

 

 

 

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107

DO NOT MAKE ANY MARKS ON THIS BOOKLET

 

PART I

 

20.

2|.

23.

24.

. My child often plays with a group of children.

. My child hardly ever smiles.

. Other children often get mad at my child.

. My child worries about things that usually only

adults worry about.

. My child has many friends.

. My child seems average or above average in

intelligence.

. My child's manners sometimes embarrass me.

. My child has a good sense of humor.

. My child sometimes sees things that aren't there.
. My child is worried about sin.

. Other children don't seem to listen to or notice my

child much.

. My child sometimes undresses outside.

. My child has little self-confidence.

. l often wish my child would be more friendly.

. My child can comb his (her) own hair.

. My child is usually rejected by other children.

. My child seems to enjoy destroying things.

. Now and then my child writes letters to friends.

. Thunder and lightning bother my child.

The school says my child needs help in getting along
with other children.

My child often asks if I love him (her).

. Other children look up to my child as a leader.

My child could ride a tricycle by age five years.

My child sometimes gets angry.

. My child frequently complains of being hot even

on cold days.

26.

27.

28.

29.

30.

3|.

32.

33.

34.

35.

36.

37.

38.

39.

40.

4|.

42.

43.

45.

47.

48.

49.

My child's behavior often makes others angry.
Recently my child has complained of eye trouble.
Others think my child is talented.

My child frequently has gas on the stomach (sour
stomach).

My child is good at lying his (her) way out of
trouble.

My child often cheats other children in deals.

My child is good at leading games and things.
At one time my child had speech difficulties.
Pestering others is a problem with my child.

My child can out things with scissors as well as can
others of his (her) age.

My child doesn‘t seem to care to be with others.

My child has difficulty doing things with his (her)
hands.

Others think my child is mean.

My child seems to know everyone in the
neighborhood.

My child would never take advantage of others.
My child can be left home alone without danger.
My child jumps from one thing to another.

My child has been in trouble for attacking others.

. My child seems too serious minded.

My child has more friends than most children.

. When my child gets mad. watch out.

My child really has no real friend.
My child is as happy as ever.

My child often complains that others don't
understand him (her).

60 ON TO THE NEXT PAGE

50.

5|.

52.

53.

55.

57.

58.

59.

6|.

62.

63.

65.

67.

68.

69.

70.

7|.

72.

73.

74.

75.

My child has very few friends.
My child likes to play active games and sports.

Sometimes I worry about my child's lack of concern
for others‘ feelings.

Often my child is afraid of little things.

. My child tends to see how much he (she) can get

away with.

My child almost never argues.

. My child often disobeys me.

My child likes to show off.
Others have said my child has a lot of “personality."

My child goes to bed on time without complaining.

. My child likes to “boss“ others around.

Reading has been a problem for my child.
A scolding is enough to make my child behave.

My child sometimes disobeys his (her) parents.

. My child is in a special class in school (for slow

learners).

My child usually plays alone.

. My child sometimes eats too many sweets.

My child often brings fn'ends home.
My child learned to count things by age six years.

My child could print his (her) first name by age six
years.

My child doesn‘t seem to learn from mistakes.

My child can't seem to wait for things like other
children do..

My child always does his (her) homework on time.
My child is usually a leader in groups.

Sometimes my child lies to avoid embarrassment
or punishment.

Other children make fun of my child's different
ideas.

108

76.
77.

78.

79.

80.

82.
83.
84.
85.

86.

87.

89.
90.
9|.
92.
93.
94.
95.
96.

97.

98.

IOO.

l0.

Sometimes my child's muscles twitch.
My child worries about talking to others.

My child first talked before he (she) was two years
old.

School teachers complain that my child can't sit
still.

My child has some bad habits.

Several times my child has spoken of a lump in his
(her) throat.

My child frequently has nightmares.
My child almost never acts selfishly.
My child is usually in good spirits.
My child seems fearful of blood.

My child seems more clumsy than other children
his (her) age.

My child will do anything on a dare.

My child sometimes becomes envious of the
possessions or good fortune of others.

Shyness is my child’s biggest trouble.
Usually my child gets along well with others.
My child gets lost easily.

My child often has headaches.

My child seems to get along with everyone.
My child is easily embarrassed.

My child is very popular with other children.

My child gets confused easily.
My child is almost always smiling.

My child loses most friends because of his (or her)
temper.

. My child is shy with children his (her) own age.

My child was difficult to toilet train.

My child wants a lot of attention when sick.

GO ON TO THE NEXT PAGE

|02.

l03.

IDS.

l06.

|07.

|08.

HO.

”2.

”3.

H4.

IIS.

“6.

“7.

“9.

l23.

124.
l25.

l26.

|27.

My child cancount change when buying something.

My child can tell the time fairly well.

. Many times my child has become violent.

My child can take a bath by him (her) self.
Recently my child has complained of chest pains.

There is seldom a need to correct or criticize my
child.

My child has as much pep and energy as most
children.

. Recently the school has sent home notes about my

child's bad behavior.

Sometimes my child will put off doing a chore.
My child often talks about death.

My child has been difficult to manage.
Sometimes my child's room is messy.

My child is usually afraid to meet new people.
My child almost never needs punishing or scolding.
My child could eat witha fork before age four years.

Often my child complains of blurring (blurred
vision).

My child needs protection from everyday dangers.

My child respects the property of others.

. Frequently my child will put his (her) hands over

his (her) ears.

. Everything has to be perfect or my child isn't

satisfied.

. Spanking doesn't seem to affect my child.

My child talks a lot about his (her) size or weight.

My child often will cry for no apparent reason.

My child will worry a lot before starting something
new.

My child usually looks at the bright side of things.

My child often has crying spells.

109

l28.

129.

I30.

l3l.

Sometimes my child gets hot all over without
reason.

My child seems tired most of the time.
Others have remarked how smart my child is.

My child takes illness harder than most children.

GO ON TO THE NEXT PAGE
(unless instructed to stop at the end of Part I)

 

110

 

 

PART 11
132. My child tends to pity him (her) self. 158. Most of my child's friends are younger than he
(she) is.
133. Others always listen when my child speaks.
159. There is a lot of swearing at our house.
134. Several times my child had complaints. but the
doctor could find nothing wrong. 160. My child never takes the lead in things.
I35. I often wonder if my child is lonely. I61. My child takes criticism easily.
I36. Usually my child takes things in stride. I62. My child sometimes swears at me.
137. My child is likely to take remarks the wrong way. 163. My child is not worried about disease.
138. Little things upset my child. I64. My child seems bored with school.
139. My child keeps thoughts to him (her) self. 165. The child‘s parents are now separated or divorced.
140. It has been a long time since our family has gone 166. My child gets exhausted so easily.
out together.
I67. I can't get my child to do his (her) school lessons.
141. My child has never mentioned his (her) heart racing
or pounding. 168. My child stays close to me when we go out.
I42. My child has usually been a quiet child. I69. Often my child goes about wringing his(her) hands.
' 143. At times my child has seriously hurt others. I70. The child‘s parents have broken up their marriage
several times.
I44. My child has never had cramps in the legs.
I71. Sometimes my child runs errands for me.
145. At times my child yells out for no reason.
172. It is not too unlikely that my child will stay in the
I46. My child is liable to scream if disturbed. house for days at a time.
147. My child has no special talents. I73. My child has had brief periods oftime when he(she)
seems unaware of everything that is gomg on.
148. Our family seems to enjoy each other more than
most families. I74. My child has never had face twitchings.
I49. My child broods some. I75. My child usually runs rather than walks.
150. My child could do better in school if he(she)tried. 176. My child is different from most children.
151. My child never liked to be cuddled. , . . .
. 177. My child is afraid of dying.
152. Our marria c has been ve unstable shak .
. 8 W ( Y) I78. My child believes in God.
153. The child‘s father seems jealous of the child. .
179. My child doesn't seem to care for fun.
154. 1 am afraid my child might be going insane. . ,
180. Often my child will sleep most of the day on a
155. My child seldom talks about sickness. hOI'd’y‘
156. My child has had convulsions. 181. My child often stays in his (her) room for hours.
157. My child often gets up at night. I82. My child has never had any paralysis.

GO ON TO THE NEXT PAGE

 

183.

I84.

I85.

I86.

187.

'88.

189.

I90.

I91.

I92.

I93.

I94.

I95.

I97.

I98.

I99.

200.

201.

202.

203.

204.

205.

206.

207.

208

My child seldom breaks rules.

How to raise the child has never been a problem
at our house.

Several times my child has threatened to kill him
(her) self.

My child usually doesn‘t trust others.

My child has many friends of the opposite sex.
My child seems unhappy about our home life.
Others often remark how moody my child is.

The trouble with my child is a “chip on the shoulder.“
Nothing seems to scare my child.

My child doesn‘t seem to be interested in practical
things.

My child can‘t seem to keep attention on anything.

The child‘s parents are not active in community
affairs.

My child tends to swallow food without chewing it.

. My child loves to stay overnight at a f riend‘s house.

School has been easy for my child.

My child can‘t sit still in school because of
nervousness.

I do not approve of most of my child‘s friends.
Constipation has never been a problem for my child.
My child is often restless.

Several times my child has been in trouble for
stealing.

My child seldom complains of stomachaches.
My child has never failed a grade in school.
My child is afraid of strangers.

The child's parents can't seem to live within their
income.

My child loves to work with numbers.

My child has never been in trouble with the police.

111

209 .

210.

211.

212.

213.

214.

215.

216.

217.

218.

219.

220.

221.

222.

223.

224.

225.

226.

227.

228.

229.

230.

23.

232.

233.

My child seldom visits a doctor.

My child's favorite stories are fairy tales or nursery
rhymes.

The child‘s father doesn't understand the child.
Dizzy spells are no problem with my child.
The child's father drinks too much.

My child tends to brag.

My child would rather be with adults than with
children his (her) own age.

My child tends to be pretty stubborn.

My child seldom talks.

Our whole family seldom gets to eat together.
Reading is my child’s favorite pastime.

The child's father usually makes the important
decisions at our house.

“Bad days” are frequent with my child.

My child insists on keeping the light on while
sleeping.

My child seems to prefer adults to children.

My child is dependent on others.

My child gets common colds more often than most
children.

The child's parents disagree a lot about rearing the
child.

Often my child locks himself (herself) in the
bedroom.

Often my child will laugh for no apparent reason.
My child sometimes skips school.
My child is not as strong as most children.

Others have remarked how self-confident my child
is in a group.

Others often remark how sensible my child is.

My child seems to understand everything that
is said.

60 ON TO THE NEXT PAGE

 

234.

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112

Sometimes the child‘s father will go away for days
after an argument.

Money seems to be my child's biggest interest.

I have often found my child playing in the toilet.
The child‘s father sometimes gets drunk and mean.
My child is a healthy child.

My child thinks others are plotting against him
(or her).

Usually my child plays inside.

. The child‘s father seldom misses work.

Often my child takes walks alone.

The child's parents have set firm rules that must
be obeyed.

Often my child will wander about aimlessly.
Several times my child has threatened to run away.
At times my child has difficulty breathing.

There is always a lot of argument at our dinner
table.

My child plays with friends who are often in trouble.
My child seldom has nose bleeds.

My child has never been expelled from school.
My child whines a lot.

My child has never run away from home.

My child shows unusual talent.

Speaking up is no problem for my child.

1 had an especially difficult time with temper
tantrums in my child at an early age.

Sharing things has been no problem for my child.

The child's parents always discuss important
matters before making a decision.

My child smokes at home.
The child‘s father frequently “blows up" at the child.

My child is shy with adults.

261.

262.

263.

264.

265.

266.

267.

268.

269.

270.

272.

273.

274.

275.

276.

277.

278.

279.

280.

I have heard that my child drinks alcohol.
My child is rather absent-minded.
My child is afraid of the dark.

My child boasts about being sent to the principal
in school.

My child never has fainting spells.

The child's father is too strict with the child.

My child will never clean his (or her) room.

My child is able to keep out of everyday dangers.

Most of my child's time is taken up watching

. television.

Frequently my child has a high fever.

. The child's father is hardly ever home.

Sometimes I don‘t understand what my child means.
My child is exceptionally neat and clean.

My child speaks of him (her) self as stupid or dumb.
There is a lot of tension in our home.

Several times my child has threatened to kill others.

The child‘s father spends very little time with the
child.

My child seldom has back pains.

The child's father has very little patience with
the child.

The child‘s parents frequently quarrel.

GO ON TO THE NEXT PAGE
(unless instructed to stop at the end of Part II)

1.13

 

Instructions: Below is a list of items concerning children's

behavior or the problems they sometimes have.

Please read each

item carefully. After you have done so please fill in one of
the numbered spaces to the right that best describes how much
you think your child has been bothered by this problem during
the past month. Mark ONLY ONE numbered space for each item

and do not skip any items.

00 NOT USE A BALLPOINT PEN. If

you change your mind, erase your first mark completely.
Please do not make any extra marks on the sheet. Please read

the example before beginning.

Definition of the Four Scale Points:

0....NOT AT ALL

1....JUST A LITTLE
2....PRETTY HUCH

3. . . .VERY MUCH

Example: Doesn't clean up his/her room........................
By filling in space 1;this person answered that his/her child

doesn't clean up hiS/her room "just a little."

p—s

behavior.

0

‘0 m N 0‘ U‘ 5 (a) N
e

attention span.

. Disturbs other children...................................
. Restless or overactive....................................
Has temper outbursts, explosive and unpredictable.........
Inattentive. easily distracted............................
Constantly fidgeting; restless in the "squirmy" sense.....
Excitable. impulsive......................................
Demands must be met immediately; easily frustrated........
Cries often and easily....................................

Fails to finish things he/she starts; short...-...........

10. Mood changes quickly and drastically......................

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114

 

Instructions: Below is a list of items concerning children's
behavior or the problems they sometimes have. Please read each

 

item carefully. After you have done so please fill in one of ;_ g .I ‘LIchig
the numbered spaces to the right that best describes how much

you think your child has been bothered by this problem during Q;g_:.sigvgygy()()(j
the past month. Mark ONLY ONE numbered space for each item

and do not skip any items. 00 NOT USE A BALLPOINT PEN. 1f {)gi(;fhb-;\CIQIC)C“
you change your mind, erase your first mark completely.

Please do not make any extra marks on the sheet. Please read 'izir,vu_-f~CIQ,C)C-

the example before beginning.

Definition of the Four Scale Points:

0....HOT AT ALL

1....JUST A LITTLE (DQQH:W;IC}C)CDCDCD<3

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Example: Doesn't clean up his/her room........................ Ajagifv_»f~jujr;wgnj
By filling in space 1 this person answered that his/her child ,qglf.....k.{fl.“{3(~_
doesn't clean up hiS/her room "just a little." ‘ “ ‘ ‘ ' ' “ “ “

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behavior. fl - -,..- _ _wfi(fi fl

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5. Constantly fidgeting; restless in the "squinmy" sense..... (INC.L9L‘CJCDQDCDCDCZ
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attention span. 11w-.-l_,qgfi,.,\,fi,.

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‘I..- c L : COL.

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Gelfand, D.M. 8 Hartmann, D.P. (1975). Child behavior analysis and
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Goodenough, F.L. (1931). Anger in young children. Minneapolis:
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Goyette, C.H., Conners, C.K., 8 Ulrich, R.F. (1978). Normative data
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